Ondansetron versus placebo for the control of nausea and vomiting during Caesarean section under spinal anaesthesia (original) (raw)
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Journal of Babol University of Medical Sciences, 2022
Background and Objective: Hypotension and bradycardia are among the common side effects of spinal anesthesia. The effect of ondansetron on the reduction of hypotension and bradycardia caused by spinal anesthesia has been studied considering its antagonistic effect on the Bezold–Jarisch reflex. The present study was conducted to determine the effectiveness of two different doses of intravenous ondansetron on the reduction of the incidence of hypotension and bradycardia among candidates for elective caesarean section under spinal anesthesia. Methods: This double-blind clinical trial was conducted in Shahid Beheshti Hospital in Isfahan in 2020 and included 90 patients aged 18 to 45 years in full-term pregnancy who were candidates for elective caesarean section in three groups of 30. 5 minutes before spinal anesthesia, 6 and 8 mg of ondansetron were injected in the first and second groups, respectively, and normal saline was injected in the third group. Vital signs were examined every 15 minutes during surgery and during recovery, and the incidence of hemodynamic disorders, nausea and vomiting was compared between the three groups. Findings: There was no significant difference between the three groups in terms of demographic and baseline variables, blood pressure (systolic, diastolic and mean arterial pressure), heart rate, ephedrine intake and incidence of hemodynamic disorders. The frequency of nausea during recovery was significantly different between the three groups (p=0.035); 12 people in the ondansetron 6 mg group, 12 people in the ondansetron 8 mg group and 21 people in the control group had nausea during recovery (40%, 40%, and 70%, respectively). The frequency of vomiting in recovery was significantly different between the three groups (p=0.002); 5 people in the ondansetron 6 mg group, 1 person in the ondansetron 8 mg group, and 12 people in the control group experienced vomiting during recovery (16.7%, 3.3%, and 40%, respectively). Conclusion: The results of this study showed that administration of ondansetron at 6 and 8 mg doses in caesarean section under spinal anesthesia has no significant effect in reducing the incidence of hypotension, bradycardia, and administration of ephedrine and atropine. However, it is associated with a reduction in the incidence of nausea and vomiting in the recovery room (ondansetron 8 mg is more effective than 6 mg).
Innovative publication, 2016
Background: Caesarean deliveries done under spinal anesthesia are associated with higher incidence of post-operative nausea and vomiting (PONV). Aims and Objectives: Present study was performed to find the efficacy of subhypnotic dose of propofol compared to ondansetron and placebo in controlling nausea and vomiting during caesarean delivery under spinal anesthesia. Material and Methods: A randomized placebo controlled study was done on 90 parturient patients at GMC and Hamidia Hospital, Bhopal between May 2013 and December 2013. All the study patients were randomly divided into three groups: Group I (Placebo treated), Group II (1 mg/kg/hr infusion of propofol) and Group III (4 mg of Ondansetron). Emetic episodes (nausea and vomiting) were evaluated using linear numerical scale ranging from 0 (No nausea and vomiting) to 2 (Vomiting). Results: In present study we found that on administration of study drugs incidence of PONV was low (13.33%) in propofol group as compared to ondansetron group (16.66%) (p >0.05). Incidence of PONV was significantly more in placebo treated group (53.33%). Conclusion: Propofol and ondansetron, both were highly effective as compared to placebo in preventing the emetic episodes during caesarean delivery under spinal anesthesia. Moreover subhypnotic dose of propofol was more effective than ondansetron in the prevention of PONV.
Advanced Biomedical Research, 2015
Background: Nausea and vomiting are frequently seen in patients undergoing cesarean section (CS) under regional anesthesia. We aimed to compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the use of each agent alone to decrease the incidence of postdelivery intra-and post-operative nausea and vomiting during CS under spinal anesthesia. Materials and Methods: A randomized, prospective, double-blind study was performed on 90 patients undergoing planned CS under spinal anesthesia. The patients received 4 mg ondansetron in Group O, 8 mg dexamethasone in Group D, and 4 mg ondansetron +8 mg dexamethasone in Group OD intravenously within 1-2 min after the umbilical cord was clamped. Frequency of postdelivery intra-and post-operative nausea and vomiting episodes was recorded. Results: A total of 90 eligible patients were included in the study. There were 30 patients in Group O, 30 patients in Group D, and 30 patients in Group OD. Intraoperative nausea in Group D was more than the other two groups. Postoperative nausea in group OD was lesser than the other two groups. Intraoperative vomiting in Group OD was lesser than the other two groups. There was no statistically significant difference among the groups in postoperative vomiting (P > 0.05). Conclusion: Combined use of dexamethasone and ondansetron for the same indication seems to increase the antiemetic efficacy.
2021
Background: Hypotension is one of the most common intra-operative complications associated with spinal anaesthe-sia. Its incidence in caesarean section has been estimated to be as high as 50-60%. Despite fluid preloading, lateral uterine displacement and the use of vasopressor agents. It occurs due to sympathetic block which leads to autonomic nervous system disturbances and a decrease in systemic vascular resistance. This can occur because the level of block must be at least at T4 to ensure adequate analgesia severe hypotension following spinal anaesthesia in caesarean section is a dangerous com-plication. If it is unnoticed or inadequately treated, it can lead to serious maternal or fetal compromise. Aim of Study: To evaluate the effect of two doses of prophylactic ondansetron on spinal anesthesia-induced hypo-tension and bradycardia among patients undergoing elective cesarean deliveries. Patients and Methods: This study was carried out in Ain Shams Hospital Obstetric Theatres fro...
2021
Introduction Hypotension is one of the most common complications associated with spinal anaesthesia. Maternal hypotension during caesarean section is more dangerous as it can compromise fetal outcome. Serotonin (5-HT3) has been found to induce Bezold Jarisch Reflex (BJR) causing bradycardia and hypotension in background of decreased blood volume. Ondansetron, a serotonin antagonist may play important role in prevention of spinal induced hypotension. The aim of this study is to determine the effect of intravenous ondansetron to prevent spinal induced hypotension during caesarean section. Methods A prospective randomised double blind study was done among singleton parturients scheduled for elective caesarean delivery under spinal anaesthesia from 2 nd July 2020 to 31 st October 2021 in College of Medical Sciences Teaching Hospital. One hundred and thirty patients were randomised by lottery method into two groups (group S and group O) each with 65 patients to receive either 4 mg of intravenous (IV) ondansetron diluted in 10 ml of normal saline or 10 ml of normal saline alone. Various haemodynamic parameters like systolic and diastolic blood pressure (SBP/DBP), mean arterial pressure (MAP), heart rate (HR), oxygen saturation (Spo 2) and vasopressor requirement were compared between the two groups using SPSS 20. Student's t test and chi-square test were used for comparison of parametric and non-parametric data. Results Incidence of hypotension was 28 (43.07%) in saline group and 11 (16.92%) in ondansetron group. There were statistically significant differences in SBP, DBP and MAP at three, six, nine twelve, fifteen and eighteen minutes. Incidence of shivering was 15 (23.07%) in ondansetron while 28 (43.07%) in saline group which was statistically significant. No other benefit of ondansetron was observed in present study. Conclusions Prophylactic administration of IV ondansetron could significantly reduce the incidence of spinal induced hypotension during caesarean section.
Galen Medical Journal, 2016
Background: Several methods are used for the prevention or decreasing the incidence of spinal anesthesia hemodynamic complications. Ondansetron is a 5HT3 receptor antagonist with known efficacy on preventing nausea and vomiting and probably on intrathecal opioid-induced pruritus. The present study aims to evaluate the effects of intravenous Ondansetron on the attenuation of blood pressure and heart rate, by 5HT3 blocking in vagal nerve endings and effect on Bezold Jarish reflex. Material and Methods: One hundred and two candidates for elective cesarean section were randomized into 2 groups of 51 cases, the Ondansetron group received 4mg Ondansetron intravenously before performing spinal anesthesia, and placebo group received 2cc sterile water. Hypotension was defined: Systolic blood pressure less than 100 MmHg or fall more than 20% from primary BP which was treated by administration of Ephedrine in case of any. In both groups, Ondansetron effect was studied on hypotension occurrence...
Egyptian Journal of Anaesthesia, 2013
Background: Spinal anesthesia has many advantages for cesarean section parturients, but hypotension is considered the most frequent complication and can be managed by different interventions. One of these interventions is to give a serotonin receptor antagonist prior to spinal anesthesia. Objectives: To compare between two serotonin receptor antagonists on the hemodynamics, sensory, and motor blockade induced by intrathecal bupivacaine in parturients undergoing cesarean section. Patients and methods: Sixty patients undergoing elective cesarean section under spinal anesthesia by intrathecal bupivacaine were randomly divided into three groups (20 pregnant females of ASA I-II physical status in each group). Group O received intravenous 4 mg ondansetron diluted in 10 ml normal saline and injected over 1 min, 5 min before spinal anesthesia, group G given intravenous 1 mg granisetron by the same route and group S given 10 ml normal saline. Mean arterial blood pressure, heart rate, vasopressor use, sensory, and motor blockade were assessed. Results: Decreases in mean arterial pressure were significantly lower in group O than groups G and S with lower vasopressor use (P < 0.05), while there was significant faster sensory recovery in group G than groups O and S (P < 0.05). Actually, there were significant decrease in the incidence of nausea in groups O and G than group S (P = 0.008). Conclusion: In parturient females undergoing elective cesarean section, intravenous 4 mg ondansetron before subarachnoid block significantly decreased both the hypotension and the doses of vaso
Journal of Evolution of medical and Dental Sciences, 2015
To evaluate the anti-emetic efficacy of bolus doses of metoclopramide and ondansetron in preventing nausea and vomiting in caesarean section under spinal anaesthesia. METHODS: Sixty patients of ASA-Ī and ĪĪ undergoing elective caesarean section were randomly divided into 2 groups of 30 each. Group A (n=30) received IV metoclopramide 10mg and Group B (n=30) received IV ondansetron 4mg, 30 minutes prior to spinal anaesthesia. Anaesthetic management was standardized and incidence of nausea, retching and vomiting was compared between the two groups. RESULTS: The maternal characteristics regarding age, weight and gestational period were not significantly different between the two groups. There was also no statistically significant (p>0.05) difference of anti-emetic effects (Nausea, vomiting) between the two studied drugs. CONCLUSION: No single intervention is available to completely eliminate nausea and vomiting. Metoclopramide is as effective as ondansetron in preventing the incidence of nausea and vomiting in caesarean delivery under spinal anaesthesia.
IP innovative publication pvt. ltd, 2019
Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its advantages of rapid and predictable onset, no airway handling, safe to mother and minimal drug exposure to fetus. But spinal anaesthesia caesarean section is associated with high incidence of IONV. Role of ondansetrone as antiemetic is well established. Not many studies are there for low dose ketamine in prevention of IONV. Materials and Methods: A total of 225 pregnant patients scheduled for CS under spinal anaesthesia were included and divided into three groups Group I – Patients who received low dose ketamine, group II- Patients who received ondansetron, group III- Patients who received normal saline. The patients were compared for intraoperative hemodynamic parameters, IONV, side effects like sedation and shivering. Results: The results of this study showed low dose ketamine group (group I) 26.6% and ondansetron (group II) 32% had lower incidence of IONV in comparison to control group 49.3%. Conclusion: Low dose ketamine and ondansetron are both good agents for reduction of IONV during CS in pregnant patients under spinal anaesthesia without significant adverse effects.