Ephedrine Versus Ondansetron in the Prevention of Hypotension During Cesarean Section: A Randomized, Double Blind, Placebo-Controlled Trial: Spinal induced hypotension in parturients
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Date
2022-09-30
0000-0002-5560-2733 Journal Title
Journal ISSN
Volume Title
Publisher
Brieflands
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.