To the Editor, Spinal anesthesia is considered the technique of choice in most cesareans, with hypotension being the most common adverse effect. The symptoms that frequently accompany hypotension are: nausea, vomiting, dyspnea and neonatal deleterious effects, among them, low Apgar score and acidosis in cord blood gas analysis1. The question is what is the most effective strategy to prevent and treat hypotension secondary to spinal anesthesia for caesarean section? It is crucial in obstetric anesthesia and the response is related to the physiological events that lead to hypotension. For many years the administration of a volume of crystalloids prior to the placement of spinal anesthesia was mandatory, just as ephedrine was considered the vasopressor of choice to treat such hypotension. The available scientific evidence shows us the opposite2.