Key result
IV ondansetron before spinal anesthesia reduces vasopressor requirements and nausea during elective cesarean sections.
Why the study?
Hypotension and bradycardia are common side effects of spinal anesthesia, thought to involve the Bezold Jarisch reflex mediated by 5-HT3 receptor stimulation.
Does intravenous ondansetron before spinal anesthesia improve hemodynamics and reduce vasopressor requirements in pregnant women undergoing elective cesarean section?
RCT (n=78)
Does intravenous ondansetron before spinal anesthesia improve hemodynamics and reduce vasopressor requirements in pregnant women undergoing elective cesarean section?
Prophylactic intravenous ondansetron before spinal anesthesia for elective cesarean section stabilizes hemodynamics and reduces the need for vasopressors.
May reduce vasopressor needs and stabilize MAP during cesarean spinal anesthesia; confirms 5-HT3 blockade benefit in this RCT.
Objective: The enhanced recovery after surgery protocol has been applied more frequently in cesarean surgeries, and regional anesthesia is the first choice because of its postoperative advantages.Hypotension and bradycardia are common side effects of spinal anesthesia.Bezold Jarisch reflex, which occurs by the stimulation of 5-HT3 receptors, is thought to be effective.This study was planned as a prospective randomized study to investigate the effect of ondansetron, a 5-HT3 receptor antagonist, on hemodynamics in pregnant women undergoing cesarean section under spinal anesthesia.Method: Seventy-eight pregnant women scheduled for elective cesarean section with spinal anesthesia were included in the study.Patients were randomly divided into two groups; group 1 (n=38) received ondansetron 4 mg intravenously before spinal anesthesia, and group 2 (n=40) did not receive ondansetron.Blood pressure, peak heart rate, and vasopressor requirements were evaluated in both groups.Results: The reductions in the mean arterial pressure were significantly lower in group 2 than in group 1 at 2 and 4 minutes (p<0.05).Patients in group 1 had a lower need for vasopressors (p=0.001) and a significantly lower incidence of nausea and vomiting (p=0.01).Conclusion: When ondansetron was used before spinal anesthesia in pregnant women undergoing elective cesarean section, hemodynamics were more stable, vasopressor use was reduced, and nausea and vomiting were reported to be less.
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Ay et al. (2022) conducted an RCT in Elective cesarean section under spinal anesthesia (n=78). Ondansetron vs. No ondansetron was evaluated on Blood pressure, peak heart rate, and vasopressor requirements (p=<0.05). Intravenous ondansetron 4 mg before spinal anesthesia for elective cesarean section significantly reduced vasopressor requirements (p=0.001) and the incidence of nausea and vomiting (p=0.01).
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