Key result
Administering ondansetron 20 minutes before spinal block significantly decreased the total number of hypotensive episodes (p=0.044) and the consumption of adrenergic agonists.
Why the study?
Spinal anaesthesia for caesarean section carries side effects affecting mother and child, and ondansetron is thought to counteract spinal block-induced bradycardia and hypotension.
Does ondansetron administered 20 minutes prior to spinal anesthesia prevent hypotension in ASA I and II parturient patients undergoing elective caesarean delivery?
RCT (n=90)
double-blinded
randomized
No
Does ondansetron administered 20 minutes prior to spinal anesthesia prevent hypotension in ASA I and II parturient patients undergoing elective caesarean delivery?
p-value: p=0.044
Administering ondansetron 20 minutes before spinal anesthesia for caesarean section significantly decreases the consumption of adrenergic agonists and reduces hypotensive episodes.
Background: Risks involved in general anaesthesia has made spinal anaesthesia the standard anaesthetic technique for caesarean section. Spinal anaesthesia has its own side effects that may affect the mother and the unborn child's wellbeing. Ondansetron is a 5-HTreceptors antagonist, basically used as an antiemetic drug and is thought to counteract bradycardia and hypotension induced by spinal block. The primary aim of the study was to assess systolic blood pressure (SBP), diastolic blood pressure (DBP), and the mean arterial pressure (MAP) among different ondansetron doses and a control group in different time intervals. Methods:Aprospective, double-blinded, placebo- controlled, randomized clinical trial was conducted during a period of 6 months on a total of 90 patients, scheduled to undergo elective caesarean delivery under spinal anesthesia, in SMGS Hospital, Jammu. All patients with ASAI and II parturient, who were included in the study. Results: Number of patients with hypotension, was not signicantly different between the study groups. Total number of hypotensive episodes showed signicant difference and was lower in Group 2. (p=0.044) Patients of group 1 had increased frequency of administration of mephtermine in response to fall in blood pressure.In Ondansetron group, there was a dose dependant decrease in ephedrine requirement. Conclusion: Administering ondansetron (6 mg) 20 minutes before spinal block can raise the hope of increasing the efcacy of Spinal anesthesia. It may not cause reduction in the incidence of hypotension in caesarean section under spinal block, but can signicantly decrease the consumption of adrenergic agonists.
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Jandial et al. (2022) conducted an RCT in elective caesarean delivery under spinal anesthesia (n=90). Ondansetron vs. placebo was evaluated on systolic blood pressure (SBP), diastolic blood pressure (DBP), and the mean arterial pressure (MAP) (p=0.044). Administering ondansetron 20 minutes before spinal block significantly decreased the total number of hypotensive episodes (p=0.044) and the consumption of adrenergic agonists.
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