Key result
Premedication with 1 mg intravenous granisetron before spinal anesthesia in elective cesarean section significantly reduced the incidence of hypotension to 3% compared to 64% with placebo.
Why the study?
Does intravenous granisetron prevent hypotension and bradycardia during spinal anesthesia in parturients undergoing elective cesarean delivery?
RCT (n=200)
Double-blind
Computer-based random number generator in permutated blocks
No
Does intravenous granisetron prevent hypotension and bradycardia during spinal anesthesia in parturients undergoing elective cesarean delivery?
Absolute Event Rate: 3% vs 64%
p-value: p=<0.0001
Premedication with 1 mg intravenous granisetron before spinal anesthesia in elective cesarean section significantly reduces the incidence of hypotension, bradycardia, and the need for vasopressors.
Supports granisetron premedication before spinal anesthesia for cesarean delivery; confirms 5-HT3 antagonist efficacy for maternal hemodynamic stability.
BACKGROUND AND AIMS: This study was conducted to determine the effectiveness of intravenous (IV) granisetron in the prevention of hypotension and bradycardia during spinal anesthesia in cesarean delivery. MATERIAL AND METHODS: A total of 200 parturients scheduled for elective cesarean section were included in this study. They were randomly divided into two groups. Group I was given 1 mg granisetron diluted in 10 ml normal saline slowly IV, 5 min before spinal anesthesia. Group II was given 10 ml of normal saline, 5 min before spinal anesthesia. Mean arterial blood pressure and heart rate (HR) were recorded every 3 min until the end of surgery (for 45 min). The total consumption of vasopressors and atropine were recorded. Apgar scores at 1 and 5 min were also assessed. RESULTS: Serial mean arterial blood pressure and HR values for 45 min after onset of spinal anesthesia were decreased significantly in group II, P < 0.0001. The incidence of hypotension after spinal anesthesia was 64% in group II and 3% in group I (P < 0.0001). The total doses of ephedrine (4.07 ± 3.87 mg vs 10.7 ± 8.9 mg, P < 0.0001), phenylephrine (0.0 microg vs 23.2 ± 55.1 microg, P < 0.0001), and atropine (0.0 mg vs 0.35 ± 0.49 mg P < 0.0001) consumed in both the groups respectively, were significantly less in group I versus group II. CONCLUSION: Premedication with 1 mg IV granisetron before spinal anesthesia in an elective cesarean section significantly reduces hypotension, bradycardia and vasopressors usage.
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Amr et al. (2015) conducted an RCT in Elective cesarean section under spinal anesthesia (n=200). Granisetron vs. Placebo (normal saline) was evaluated on Incidence of hypotension (p=<0.0001). Premedication with 1 mg intravenous granisetron before spinal anesthesia in elective cesarean section significantly reduced the incidence of hypotension to 3% compared to 64% with placebo.
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