A Double Blind Randomized, Placebo Controlled Study Evaluating the Effect of Ondansetron in Reducing Spinal- Induced Hypotension Using Low Dose Bupivacaine in Parturients Undergoing Caesarean Section.
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Date
2016-03
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Abstract
Background: Spinal induced hypotension is the most common intraoperative complication after spinal anesthesia
during cesarean delivery. Various adjuvant techniques/drugs had been used in the past to minimize the haemodynamic
effects of spinal anaesthesia. Five-hydroxytriptamine (5-HT), a serotonergic receptor, may be an important factor
associated with inducing the Bezold Jarish reflex (BJR) that may lead to the bradycardia and hypotension in the setting
of decreased blood volume. Some animal and human studies further supported that BJR can be decreased by 5-HT3
antagonists. Aim: The present study work is to assess the effects of Inj. Ondansetron (a selective 5‑HT3 receptor
antagonist) in preventing spinal induced hypotension in patient undergoing elective Caesarean section. Methods: Sixty
parturients scheduled for elective caesarean section were randomly allocated into two groups. Group O (30 patients):
Inj. Ondansetron (4 mg IV) diluted in 10 mL of normal saline, administered 5 minutes before spinal anaesthesia and
Group N (30 patients): Normal saline 10 mL given 5 minutes before spinal anaesthesia. We observed the
haemodynamic parameters as our primary outcome and neonatal outcome in terms of APGAR scoring as secondary
outcome. Results: Both the groups were comparable in terms of demographic characteristics. The decrease in mean
arterial pressure in Group O was significantly lesser than Group N from 6 min until 30 min. The requirement of
vasopressor (Inj. Phenylephrine) was significantly less in Group O than Group N (P = 0.015). Neonatal outcome in
terms of APGAR Score and gas analysis were comparable between the groups. Conclusion: Inj. Ondansetron (4 mg
IV), given intravenously 5 min before subarachnoid block reduced hypotension and vasopressor use in parturients
undergoing elective caesarean section.
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Keywords
Ondansetron, Spinal-Induced Hypotension, Low Dose Bupivacaine
Citation
Varshney Rohit Kumar, Gupta Saurabh. A Double Blind Randomized, Placebo Controlled Study Evaluating the Effect of Ondansetron in Reducing Spinal- Induced Hypotension Using Low Dose Bupivacaine in Parturients Undergoing Caesarean Section. Annals of International Medical and Dental Research. 2016 Mar-Apr; 2(2): 166-170.