Effect of Intravenous Ondansetron on Sub-Arachnoid Block Induced Hypotension and Bradycardia in Patients Undergoing Caesarean Section
Authors/Creators
- 1. Post Graduate 3rd Year, Dept of Anesthesiology, MGM Medical College and L.S.K. Hospital, Kishanganj, Bihar India
- 2. Assistant Professor, Dept of Anesthesiology, MGM Medical College and L.S.K. Hospital, Kishanganj, Bihar India
Description
Background: Spinal anesthesia is a safe and effective alternative to general anesthesia when the surgical site is located on the lower extremities, perineum (eg, surgery on the genitalia or anus), or lower body wall (eg, inguinal herniorrhaphy). Objective: To compare post spinal (SAB) haemodynamic changes (hypotension and bradycardia) between two groups. Methods: This Prospective observational study was conducted in Department of Anaesthesiology and Critical Care in M GM Medical College and LKS Hospital. ASA physical status II, between 18 to 40 years of age, parturient undergoing elective caesarean section at term was enrolled in this study. Study period was August 2022- August 2023. Results: Intra-Op pulse rate was less in Normal Saline group compared to Ondansetron group which was statistically significant. Intra-op lowest SBP, DBP and MAP were less in Normal Saline group compared to Ondansetron group which were statistically significant. Episodes of bradycardia in intra-op were more in Normal Saline group compared to Ondansetron group though it was not statistically significant. The mean Episodes of hypotension in intra-op was more in Normal Saline group compared to Ondansetron group which was statistically significant. Conclusions: Use of intravenous ondansetron before sub-arachnoid block in parturients undergoing caesarean section, causes significant reduction of hypotension and variable reduction of bradycardia intra operatively.
Abstract (English)
Background: Spinal anesthesia is a safe and effective alternative to general anesthesia when the surgical site is located on the lower extremities, perineum (eg, surgery on the genitalia or anus), or lower body wall (eg, inguinal herniorrhaphy). Objective: To compare post spinal (SAB) haemodynamic changes (hypotension and bradycardia) between two groups. Methods: This Prospective observational study was conducted in Department of Anaesthesiology and Critical Care in M GM Medical College and LKS Hospital. ASA physical status II, between 18 to 40 years of age, parturient undergoing elective caesarean section at term was enrolled in this study. Study period was August 2022- August 2023. Results: Intra-Op pulse rate was less in Normal Saline group compared to Ondansetron group which was statistically significant. Intra-op lowest SBP, DBP and MAP were less in Normal Saline group compared to Ondansetron group which were statistically significant. Episodes of bradycardia in intra-op were more in Normal Saline group compared to Ondansetron group though it was not statistically significant. The mean Episodes of hypotension in intra-op was more in Normal Saline group compared to Ondansetron group which was statistically significant. Conclusions: Use of intravenous ondansetron before sub-arachnoid block in parturients undergoing caesarean section, causes significant reduction of hypotension and variable reduction of bradycardia intra operatively.
Files
IJPCR,Vol16,Issue3,Article200.pdf
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Additional details
Dates
- Accepted
-
2024-02-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue3,Article200.pdf
- Development Status
- Active
References
- 1. Mercier FJ, Bonnet MP, De la Dorie A, Moufouki M, Banu F, Hanaf A, Edouard D, Roger-Christoph S. Spinal anaesthesia for caesarean section: fluid loading, vasopressors and hypotension. InAnnales francaises d'anesthesie et de reanimation.2007;26( 7-8) :688 2. Rout CC, Rocke DA, Levin J, Gouws E, and Reddy D. A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective cesarean section, Anesthesiology.1993; 79( 2): 262–69 3. Jackson R, Reid JA, and Thorburn J.Volume preloading is not essential to prevent spinalinduced hypotension at caesarean section. British Journal of Anaesthesia.1995; 75( 3): 262– 65 4. Emmett RS, Cyna AM, Andrew M, and Simmons SW.Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database of Systematic Reviews. 2002; 3:Article ID CD002251 5. Rooke GA, Freund PR, and Jacobson AF. Hemodynamic response and change in organ blood volume during spinal anesthesia in elderly men with cardiac disease.Anesthesia and Analgesia.1997; 85( 1): 99–105 6. Butterworth J. Physiology of spinal anesthesia: what are the implications for management?. Regional Anesthesia and Pain Medicine. 1998 ; 23(4): 370–3 7. Brooker RF, Butterworth IV JF, Kitzman DW, Berman JM, Kashtan HI, and McKinley AC. Treatment of hypotension after hyperbaric tetracaine spinal anesthesia: a randomized, double-blind, cross-over comparison of phenylephrine and epinephrine. Anesthesiology1997; 86( 4):797–805 8. Yamano M, Kamato T, Nishida A et al. Serotonin (5-HT) 3-receptor antagonism of 4,5,6,7- tetrahydrobenzimidazole derivatives against SHT-induced bradycardia in anesthetized rats. Japanese Journal of Pharmacology.1994; 65( 3): 241–8 9. Owczuk R, Wenski W, Polak-Krzeminska A, Twardowski P, Arszułowicz R, DylczykSommer A, Wujtewicz MA, Sawicka W, Morzuch E, Smietanski M, Wujtewicz M. Ondansetron given intravenously attenuates arterial blood pressure drop due to spinal anesthesia: a double-blind, placebo-controlled study. Regional Anesthesia & Pain Medicine. 2008; 33(4):332-9. 10. Lahsaei SM, Amini A, Tabatabei SM, Mehrabani G. A comparison between cetirizine and ondansetron in preventing postoperative nausea and vomiting in adults. J Res Med Sci.2012; 17:760–3. 11. Sahoo T, SenDasgupta C, Goswami A, Hazra A. Reduction in spinal-induced hypotension with ondansetron in parturients undergoing caesarean section: a double-blind randomised, placebo-controlled study. International journal of obstetric anesthesia. 2012; 21(1):24-8. 12. Tatikonda CM, Rajappa GC, Rath P, Abbas M, Madhapura VS, Gopal NV. Effect of intravenous ondansetron on spinal anesthesia-induced hypotension and bradycardia: A randomized controlled double-blinded study. Anesthesia, Essays and Researches. 2019; 13(2):340. 13. Shabana AA, Elkholy NI, Mohamed AM, Hamid MI. Effect of ondansetron on hypotensionand bradycardia associated with spinal anesthesia during cesarean section. Menoufia Medical Journal. 2018; 31(1):12. 14. Attri A, Sharma N, Singh MR, Bansal K, Singh S. Effect of intravenous ondansetron on maternal hemodynamics during elective caesarean section under subarachnoid block. Journal of Obstetric Anaesthesia and Critical Care. 2019; 9(2):94. 15. Raghu K, Kumar S, Rajaram G, Nikhil N, Damodar P. Effect of ondansetron in the prevention of spinal anesthesia-induced hypotension. Journal of the Scientific Society. 2018; 45(3):125. 16. Shabana AA, Elkholy NI, Mohamed AM, Hamid MI. Effect of ondansetron on hypotension and bradycardia associated with spinal anesthesia during cesarean section. Menoufia Medical Journal. 2018; 31(1):12. 17. Baig R, Shah AA, Khurshid T, Abid L, Tariq Z. Use of Ondansetron for Prevention of Spinal Induced Hypotension. Journal of Islamabad Medical & Dental College. 2017; 6(4):208-13. 18. Tubog TD, Kane TD, Pugh MA. Effects of ondansetron on attenuating spinal anesthesiainduced hypotension and bradycardia in obstetric and nonobstetric subjects: a systematic review and meta-analysis. AANA J. 2017; 85(2):113-22. 19. Amanda Thornton DN, Hallie Evans DN. Utilization of Ondansetron Prior to Spinal Block to Attenuate Spinal-Induced Adverse Effects during Cesarean Section. FANA eJournal. 2019; 1. 20. Al Zahraa AA, Nassar AM, Mohamed SG. Effects of prophylactic dose of ondansetron on hemodynamics during spinal anesthesia in cesarean section. The Scientific Journal of AlAzhar Medical Faculty, Girls. 2019; 3(3):635. 21. Abbas N, Shah SA, Naqvi SS. Role of prophylactic ondansetron for prevention of spinal anaesthesia induced hypotension in lower segment caesarean section. Pakistan Armed Forces Medical Journal. 2016; 66(6):790-4. 22. Ipe S, Korula S, Varma S, George GM, Abraham SP, Koshy LR. A comparative study of intrathecal and epidural buprenorphine using combined spinal-epidural technique for caesarean section. Indian journal of anaesthesia. 2010; 54(3):205.