T Sahoo1, C SenDasgupta, A Goswami, A Hazra. 1. Department of Anaesthesiology, Institute of Post Graduate Medical Education & Research, Kolkata, India.
Abstract
BACKGROUND: Subarachnoid block is the preferred method of anaesthesia for caesarean section, but is associated with hypotension and bradycardia, which may be deleterious to both parturient and baby. Animal studies suggest that in the presence of decreased blood volume, 5-HT may be an important factor inducing the Bezold Jarisch reflex via 5-HT3 receptors located in intracardiac vagal nerve endings. In this study, we evaluated the effect of ondansetron, as a 5-HT3 receptor antagonist, on the haemodynamic response following subarachnoid block in parturients undergoing elective caesarean section. METHODS:Fifty-two parturients scheduled for elective caesarean section were randomly allocated into two groups. Before induction of spinal anaesthesia Group O (n=26) received intravenous ondansetron 4 mg; Group S (n=26) received normal saline. Blood pressure, heart rate and vasopressor requirements were assessed. RESULTS: Decreases in mean arterial pressure were significantly lower in Group O than Group S from 14 min until 35 min. Patients in Group O required significantly less vasopressor (P=0.009) and had significantly lower incidences of nausea and vomiting (P=0.049). CONCLUSION:Ondansetron 4 mg, given intravenously 5 min before subarachnoid block reduced hypotension and vasopressor use in parturients undergoing elective caesarean section.
RCT Entities:
BACKGROUND:Subarachnoid block is the preferred method of anaesthesia for caesarean section, but is associated with hypotension and bradycardia, which may be deleterious to both parturient and baby. Animal studies suggest that in the presence of decreased blood volume, 5-HT may be an important factor inducing the Bezold Jarisch reflex via 5-HT3 receptors located in intracardiac vagal nerve endings. In this study, we evaluated the effect of ondansetron, as a 5-HT3 receptor antagonist, on the haemodynamic response following subarachnoid block in parturients undergoing elective caesarean section. METHODS: Fifty-two parturients scheduled for elective caesarean section were randomly allocated into two groups. Before induction of spinal anaesthesia Group O (n=26) received intravenous ondansetron 4 mg; Group S (n=26) received normal saline. Blood pressure, heart rate and vasopressor requirements were assessed. RESULTS: Decreases in mean arterial pressure were significantly lower in Group O than Group S from 14 min until 35 min. Patients in Group O required significantly less vasopressor (P=0.009) and had significantly lower incidences of nausea and vomiting (P=0.049). CONCLUSION:Ondansetron 4 mg, given intravenously 5 min before subarachnoid block reduced hypotension and vasopressor use in parturients undergoing elective caesarean section.
Authors: James D Griffiths; Gillian M L Gyte; Shantini Paranjothy; Heather C Brown; Hannah K Broughton; Jane Thomas Journal: Cochrane Database Syst Rev Date: 2012-09-12
Authors: James D Griffiths; Gillian Ml Gyte; Phil A Popham; Kacey Williams; Shantini Paranjothy; Hannah K Broughton; Heather C Brown; Jane Thomas Journal: Cochrane Database Syst Rev Date: 2021-05-18
Authors: Cheryl Chooi; Julia J Cox; Richard S Lumb; Philippa Middleton; Mark Chemali; Richard S Emmett; Scott W Simmons; Allan M Cyna Journal: Cochrane Database Syst Rev Date: 2020-07-01
Authors: Andrea C Tricco; Charlene Soobiah; Erik Blondal; Areti A Veroniki; Paul A Khan; Afshin Vafaei; John Ivory; Lisa Strifler; Huda Ashoor; Heather MacDonald; Emily Reynen; Reid Robson; Joanne Ho; Carmen Ng; Jesmin Antony; Kelly Mrklas; Brian Hutton; Brenda R Hemmelgarn; David Moher; Sharon E Straus Journal: BMC Med Date: 2015-06-18 Impact factor: 8.775