Caffeine Before Cesarean Delivery: A Novel Preventive Strategy Against Spinal Hypotension, A Double Blind Placebo‐controlled Trial

J Anesth Analg Crit Care . 2026 Jan 15;6(1):12. doi:10.1186/s44158-025-00333-z Spinal anesthesia is widely regarded as the preferred technique for cesarean delivery (CD) because it provides a rapid onset, high maternal satisfaction, and avoids airway manipulation. Despite these advantages, spinal anesthesia-induced hypotension (SAIH) remains a frequent and clinically significant complication, with reported rates as high as 70%. It is typically defined as a reduction in systolic blood pressure (SBP) of more than 20% from baseline or an absolute SBP below 100 mm Hg. In obstetric patients, untreated hypotension may compromise maternal organ perfusion and reduce uteroplacental blood flow, potentially leading to fetal acidosis and bradycardia. Although fluid loading, vasopressors, and mechanical positioning strategies are commonly used, hypotension remains prevalent, highlighting the need for simple, safe preventive interventions.