Effect of Prophylactic Ondansetron on the Incidence of Spinal-anesthesia-induced Shivering and Hypotension in Elective Cesarean Sections: A Prospective, Randomized, Placebo-Controlled, Double-Blind Study
Files
Date
2020-05-07
Authors
Salahat, Ahmad
Journal Title
Journal ISSN
Volume Title
Publisher
Ahmad Mutlaq Salahat
Abstract
Background: Spinal anesthesia is the preferred method of anesthesia for cesarean section, but it is associated with dangerous adverse effects to the mother and fetus, this includes: hypotension and shivering. Studies suggest serotonin may have role in hypotension, bradycardia and shivering occurrence. In this study, we evaluated the efficacy of ondansetron, a serotonin receptor antagonist, on the incidence of spinal-anesthesia-induced shivering, hypotension, nausea, vomiting and other complications in elective cesarean sections.
Methods: this was double blinded RCT, were 80 full-term parturient were randomly allocated into two groups, immediately before induction time, the treatment group received an IV bolus of 4 mg ondansetron and the control group received IV 10 ml of 0.9% saline. Study observations and hemodynamic parameters were recorded pre-, intra-, and postoperatively: every 3 min intraoperatively and every 5 min for 15 min in the post-anesthesia care unit.
Results: there was significant difference between both study groups in regard to: incidences of intraoperative hypotension and dizziness there were 25/40 cases (62.5%) in control group vs 9/40 cases (22.5%) in ondansetron group (P < 0.001), incidences and intensity of intraoperative shivering there were 13/40 cases (32.5 %) in control group vs 5/40 cases (12.5 %) in ondansetron group (P = 0.032). Intraoperative nausea intensity was lower in ondansetron group (P = 0.049). Postoperatively, incidences of dizziness where 15/40 cases (37.5 %) in control group vs 2/40 cases (5 %) in ondansetron group (P =0.001), incidences and intensity of postoperative shivering where 15/40 cases (37.5 %) in control group vs only 5/40 cases (12.5 %) in ondansetron group (P = 0.010). Incidences and intensity of postoperative nausea where 16/40 cases (40 %) in control group vs only 7/40 cases (17.5 %) in ondansetron group (P = 0.026), postoperative vomiting, incidences where 9/40 cases (25.5 %) in control group vs only 1/40 cases (2.5 %) in ondansetron group (P = 0.014).
Conclusion: prophylactic 4 mg IV ondansetron significantly attenuates the incidence of spinal anesthesia-induced shivering and hypotension, dizziness, nausea and vomiting occurrence.
Key words: Ondansetron, spinal anesthesia, cesarean section, hypotension, shivering, nausea/vomiting
Description
Keywords
Effect of Prophylactic Ondansetron on the Incidence of Spinal-anesthesia-induced Shivering and Hypotension in Elective Cesarean Sections: A Prospective, Randomized, Placebo-Controlled, Double-Blind Study