To Evaluate the Effect of Prophylactic Intravenous 8 MG Ondansetron for Attenuation of Hypotension and Bradycardia in Caesarean Section under Spinal Anaesthesia
Journal Title: Indian Journal of Obstetrics and Gynecology - Year 2018, Vol 6, Issue 5
Abstract
Aim: This prospective, randomized, double blinded study was conducted to evaluate the effect of prophylactic intravenous 8 mg ondansetron for attenuation of hypotension and bradycardia in caesarean section under spinal anaesthesia. Materials & Methods: After obtaining the approval from the ethical committee of IGMC Shimla 60 patients of ASA I and II aged 20-40 years undergoing elective caesarean section were included in the study. Group 1 received preloading with ringer lactate (500ml) thirty minutes before surgery and Ondansetron 8 mg in 5 ml NS, 5 minutes before spinal anaesthesia.Group 2 received preloading with ringer lactate (500ml) thirty minutes before surgery and 5 ml NS, 5 minutes before spinal anaesthesia. Results: Both the groups were comparable in demographic variables like age, ASA status and duration of surgery (p>0.05). The baseline haemodynamic parameters were comparable in both the groups (p>0.05). The oxyhaemoglobin saturation was comparable and there was no significant difference in both the study groups (p>0.05). The time for fixation of sensory and motor block was similar in both the groups. The heart rate at all the time intervals was comparable in both the groups with higher mean heart rate in Group 1 at 14 minutes and 16 minutes of time interval. The fall in MAP was significantly more (p=0.018) in Group 2 than in Group 1 and was seen at 2 minutes onwards whereas it was observed at 10 minutes to 25 minutes in Group 1. The mean phenylephrine consumption was more in Group 2 than in Group 1, 50µgms vs. 23±50µgms respectively, although the p value remained insignificant. (p=0.091). In our study we had significant fall in blood pressure at 2 minutes in Group 2 and the vasopressors were used more during the first 10 minutes after subarachnoid block in Group 2 as compared to Group 1. After 10 minutes, 3 patients required them to maintain BP in both the groups. In intra group comparison of blood pressure significant fall in BP from base line was observed at 10 min interval in group 1 (p=0.002). Whereas this fall was seen at 2 minutes of subarachnoid block in Group 2 (p=0.04). There were no statistically significant untoward effects observed in any of the study groups. Conclusion:- Ondansetron seems to prevent the initial fall in BP during first 10 minutes after subarachnoid block. Though Ondansetron had attenuated hypotension in the first 10 minutes with lower vasopressor usage (13% in Group 1 vs. 40% in Group 2) after spinal anaesthesia in elective caesarean section in our study but since we did not get statistically significant results in vasopressors use after 10 minutes we recommend further studies with bigger sample size to prove the hypothesis that Ondansetron use obtunds the fall in blood pressure in spinal anaesthesia in cesarean section.
Authors and Affiliations
Rao Rohini .
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- EP ID EP550048
- DOI 10.21088/ijog.2321.1636.6518.9
- Views 66
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