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Year : 2018  |  Volume : 45  |  Issue : 3  |  Page : 125-128

Effect of ondansetron in the prevention of spinal anesthesia-induced hypotension

1 Department of Anesthesiology, 4 Air Force Hospital Kalaikunda, West Midnapore, West Bengal, India
2 Department of Anaesthesiolgy, Military Hospital, Pithoragarh, Uttarakhand, India
3 Department of Anaesthesiology, 5 Air Force Hospital, Jorhat, Assam, India
4 Department of Anaesthesiology, Axon Hospitals, Bangalore, Karnataka, India
5 Department of Anaesthesiology, Command Hospital (Air Force), Bangalore, Karnataka, India

Correspondence Address:
Dr. K Raghu
Department of Anesthesiology, 4 Air Force Hospital, Kalaikunda, West Midnapore, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jss.JSS_45_18

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Background and Aims: Hypotension and bradycardia are the common side effects seen after spinal anesthesia. Multiple strategies are tested to prevent the postspinal anesthesia-induced hypotension. Recently, Ondansetron, a 5-HT3 antagonist commonly used as an antiemetic was found to be effective in preventing spinal anesthesia-induced hypotension. The aim of this study is to evaluate the effect of ondansetron in the prevention of spinal anesthesia-induced hypotension. Materials and Methods: A prospective, randomized, and double-blind study was conducted on 110 elderly patients, aged 50–70 years, of the American Society of Anesthesiologists Grade I or II category, scheduled for various surgeries under spinal anesthesia. The patients were randomly divided into two groups of 55 each to receive either ondansetron 8 mg (Group A) or saline (Group B) before spinal anesthesia. The primary outcome of the study was the incidence of hypotension (systolic blood pressure <100 mm Hg or fall >20% in the baseline values). Secondary outcomes, such as the requirement of ephedrine, the incidence of bradycardia, nausea, and vomiting were also recorded during the study. Results: Group A and Group B were comparable with respect to age, sex, height, and weight. Thirty-four patients in Group B (60.7%) and 22 patients in Group A developed hypotension (39.3%) (P = 0.0359) [Table 1]. The use of ephedrine was greater in Group B than that of Group A (mean 4.61 ± 1.80 vs. 3.45 ± 1.09, P = 0.0107). Thirteen patients in Group B and four patients in Group A had bradycardia (P = 0.0176). Nine patients in Group B and two patients in Group A had vomiting (P = 0.0261). Conclusion: We conclude that prophylactic administration of ondansetron is effective in reducing the incidence of spinal anesthesia-induced hypotension.

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