Ephedrine Versus Ondansetron in the Prevention of Hypotension During Cesarean Section: A Randomized, Double Blind, Placebo-Controlled Trial: Spinal induced hypotension in parturients

How to Cite:Ahmed Mohamed KhamisAbd El-Aziz A. Abd El-AzizRaham Hasan MostafaMohamed Abdallah NoserEphedrine Versus Ondansetron in the Prevention of Hypotension During Cesarean Section: A Randomized, Double Blind, Placebo-Controlled Trial: Spinal induced hypotension in parturients.J Cell Mol Anesth.7(3):e150196.https://doi.org/10.22037/jcma.v7i3.37841.

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

References

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Author(s):

Ahmed Mohamed Khamis:[PubMed][Scholar]
Abd El-Aziz A. Abd El-Aziz:[PubMed][Scholar]
Raham Hasan Mostafa:[PubMed][Scholar]
Mohamed Abdallah Noser:[PubMed][Scholar]