Abstract
Background: Common side effects of spinal anesthesia for cesarean section (CS) include hypotension and bradycardia. Ondansetron, a 5HT3 receptor antagonist has been suggested for prophylactic prevention of spinal?induced hypotension (SIH) in elective cesarean section.
Objective: This study was conducted to compare a traditional vasopressor ?ephedrine? with two different doses of 5-HT3 receptor antagonist ?ondansetron? in preventing SIH during cesarean section.
Patients: A total of 168 full?term parturients undergoing CS under spinal anesthesia were included.
Interventions: Patients were divided randomly into 4 groups (ephedrine, 4 mg ondansetron (O4), 8 mg ondansetron (O8) and control group). All patients were monitored for mean blood pressure, heart rate, vasopressor requirement, and side effects.
Main outcome measure: The primary outcome of this study was the incidence of SIH in all 4 groups during the first 60 minutes after spinal anesthesia
Results: The incidence of SIH was significantly higher in the control group (45,2%) when compared to ephedrine, O4, O8 groups (19%, 16.7%, 11.9% respectively). There were significant differences between the 4 groups regarding maternal mean arterial pressures during the 1st 60 minutes after spinal anesthesia. No side effects were recorded.
Conclusion: Prophylactic intravenous ondansetron - at a dose of 4mg or 8mg- could be an effective alternative to ephedrine in reducing the incidence of SIH and requirement of vasopressors in parturients undergoing CS.
Keywords
Bezold?Jarisch reflex cesarean section ephedrine ondansetron spinal induced hypotension
Copyright
© 2022, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.