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British Journal of Anaesthesia, 2000, Vol. 85, No. 2 311-313
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Brief Communication

Randomized study of intravenous fluid preload before epidural analgesia during labour

S. M. Kinsella*, M. Pirlet1, M. S. Mills2, J. P. Tuckey3 and T. A. Thomas

Sir Humphry Davy Department of Anaesthesia, St Michael’s Hospital, Southwell Street, Bristol BS2 8EG, UK. 1Department of Anaesthesia, Centre Universitaire de Santé de l’Estrie, 3001 12e Avenue Nord, Sherbrooke, Quebec, Canada J1H 5N4. 2Department of Obstetrics and Gynaecology, St Michael’s Hospital, Southwell Street, Bristol BS2 8EG. 3Department of Anaesthesia, Royal United Hospital, Combe Park, Bath BA1 3NG, UK

Abstract

We performed a randomized controlled trial of the effect of intravenous fluid preload on maternal hypotension and fetal heart rate (FHR) changes in labour after the first epidural injection. Group 1 (49 women) received 1 litre of crystalloid preload. Group 2 (46 women) received no preload. No statistically significant difference was shown between the two groups for either of the outcomes. Hypotension was found in three women in group 1 and five in group 2 (P=0.4). Deterioration in FHR pattern was found in four women in group 1 and 11 in group 2 (P=0.08). This study has not shown a significant increase in the incidence of hypotension when intravenous preload is omitted before epidural analgesia using a low concentration of bupivacaine during labour. Because of the clinical importance of the difference in the rate of FHR deterioration between the two groups, we continue to administer preload for high-risk cases.

Br J Anaesth 2000; 85: 311–3

Footnotes

* Correspondingauthor


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