Comparative Analysis of Coload and Pre-Load in the Prevention of Spinal Anesthesia Induced Hypotension

Background: Spinal anesthesia is widely used for elective lower abdominal and urologic procedures but is frequently complicated by hypotension due to sympathetic blockade, reduced venous return, and decreased cardiac output. Optimizing the timing of crystalloid administration may improve hemodynamic stability and reduce vasopressor exposure. Objective: To compare crystalloid preload versus crystalloid coload in preventing spinal anesthesia–induced hypotension and reducing vasopressor requirement in adults undergoing elective lower abdominal and urologic surgery. Methods: In this prospective comparative cross-sectional study, 44 ASA I–III patients (18–70 years) were allocated to receive Ringer’s lactate either as preload (10–15 mL/kg before intrathecal injection; n=22) or coload (same volume initiated at intrathecal injection; n=22). Hemodynamics were recorded at predefined intervals intraoperatively. Hypotension was defined as SBP decrease ≥20% from baseline or MAP