Feride Karacaer1, Ebru Biricik2, İlker Ünal3, Selim Büyükkurt4, Hakkı Ünlügenç2. 1. Department of Anesthesiology, Çukurova University School of Medicine, Sarıçam, 01330, Adana, Turkey. feridekaracaer@gmail.com. 2. Department of Anesthesiology, Çukurova University School of Medicine, Sarıçam, 01330, Adana, Turkey. 3. Department of Biostatistics, Çukurova University School of Medicine, Adana, Turkey. 4. Department of Obstetrics and Gynecology, Çukurova University School of Medicine, Adana, Turkey.
Abstract
PURPOSE:Spinal anesthesia-induced hypotension (SAIH) during cesarean delivery is not rare and frequently leads to materno-fetal discrepancy and collapse. More recently, norepinephrine has been proposed for the prevention and treatment of SAIH with fewer tendencies to decrease heart rate and cardiac output. Ondansetron has been reported to reduce the incidence of SAIH in patients undergoing cesarean section. The aim of the present study was to assess the effect of prophylactic ondansetron on the incidence of SAIH, norepinephrine consumption, and adverse effects. METHODS: We recruited 108 parturients with uncomplicated pregnancies undergoing elective cesarean delivery under spinal anesthesia. The parturients were divided into two groups randomly. The first group (n = 54) received 8 mg ondansetron IV (group O) and the second group (n = 54) received the same volume (4 ml) of saline (group S), 5 min before spinal anesthesia. The incidence of hypotension, cumulative episodes of hypotension, total norepinephrine consumption, and adverse effects were recorded. RESULTS: There was no significant difference between the two groups in demographic data, parturient characteristics, and duration of surgery. No significant difference was found in the incidence of hypotension in the saline and ondansetron groups (p = 0.767). However, the cumulative episodes of hypotension and norepinephrine consumptions were significantly greater in group S than in group O (p = 0.009) (p = 0.009). There was also no significant difference in the incidence of adverse effects between the two groups. CONCLUSION: Eight milligrams of intravenous ondansetron given 5 min before spinal anesthesia attenuated but did not prevent spinal anesthesia-induced hypotension in parturients undergoing elective cesarean delivery.
RCT Entities:
PURPOSE: Spinal anesthesia-induced hypotension (SAIH) during cesarean delivery is not rare and frequently leads to materno-fetal discrepancy and collapse. More recently, norepinephrine has been proposed for the prevention and treatment of SAIH with fewer tendencies to decrease heart rate and cardiac output. Ondansetron has been reported to reduce the incidence of SAIH in patients undergoing cesarean section. The aim of the present study was to assess the effect of prophylactic ondansetron on the incidence of SAIH, norepinephrine consumption, and adverse effects. METHODS: We recruited 108 parturients with uncomplicated pregnancies undergoing elective cesarean delivery under spinal anesthesia. The parturients were divided into two groups randomly. The first group (n = 54) received 8 mg ondansetron IV (group O) and the second group (n = 54) received the same volume (4 ml) of saline (group S), 5 min before spinal anesthesia. The incidence of hypotension, cumulative episodes of hypotension, total norepinephrine consumption, and adverse effects were recorded. RESULTS: There was no significant difference between the two groups in demographic data, parturient characteristics, and duration of surgery. No significant difference was found in the incidence of hypotension in the saline and ondansetron groups (p = 0.767). However, the cumulative episodes of hypotension and norepinephrine consumptions were significantly greater in group S than in group O (p = 0.009) (p = 0.009). There was also no significant difference in the incidence of adverse effects between the two groups. CONCLUSION: Eight milligrams of intravenous ondansetron given 5 min before spinal anesthesia attenuated but did not prevent spinal anesthesia-induced hypotension in parturients undergoing elective cesarean delivery.
Authors: Abdullah S Terkawi; Mohamed Tiouririne; Sachin H Mehta; Jordan M Hackworth; Siny Tsang; Marcel E Durieux Journal: Reg Anesth Pain Med Date: 2015 Jul-Aug Impact factor: 6.288
Authors: J R Ortiz-Gómez; F J Palacio-Abizanda; F Morillas-Ramirez; I Fornet-Ruiz; A Lorenzo-Jiménez; M L Bermejo-Albares Journal: Int J Obstet Anesth Date: 2014-02-04 Impact factor: 2.603
Authors: Desire N Onwochei; Warwick D Ngan Kee; Lillia Fung; Kristi Downey; Xiang Y Ye; Jose C A Carvalho Journal: Anesth Analg Date: 2017-07 Impact factor: 5.108