Effectiveness of prophylactic ondansetron in preventing spinal anesthesia induced hypotension and bradycardia in pregnant mother undergoing elective cesarean delivery: A double blinded randomized control trial, 2021

Abstract

BackgroundSpinal anesthesia is the most common techniques of regional anesthesia for cesarean section. However, hypotension is the most common complication associated with nausea and vomiting, altered mental status and risk of aspiration. Bradycardia is also a common feature of profound circulatory collapse under neuraxial anesthesia. After verification that, serotonin can induce BJR reflex and can causes bradycardia or hypotension, researchers started to evaluate the effect of ondansetron to decrease BJR reflex in human being. ObjectivesTo assess the effect of prophylactic ondansetron for prevention of spinal induced hypotension and bradycardia in parturients undergoing cesarean delivery from June 1, 2020 to January 30, 2021. Methodology: A double blinded randomized control trial conducted in Dilla university referral hospital by recruiting 70 patients with systematic random sampling technique. Patients were randomized into ondansetron group (n = 35) and control group (n = 35). Mann Whitney U test was used for continuous non-normally distributed data and independent sample t-test for normally distributed data. Mixed ANOVA was used to analysis the interaction of the within and between factors. Categorical variable between the groups were analyzed using fisher exact and chi square test. p -value<0.05 is considered statically significant. ResultThere were no significant differences in the incidence of hypotension between ondansetron (20(57) and saline group (21(60%)). There were no significant difference in incidence of bradycardia among the two groups p > 0.05. Perioperative Phenylephrine consumption was 36.43 ± 45.91 mcg and 32.14 ± 46.79 mcg in ondansetron and saline group respectively with P = 0.700. The incidence of shivering was lower in ondansetron group (11%) than saline group (45%) with (p = 0.04) and the perioperative rescue shivering requirement was higher in saline group (p = 0.00). Conclusionand Recommendations: Prophylaxis administration of intravenous Ondansetron at a dose of 10 mg before spinal anesthesia was not effective in reducing the incidence of hypotension and bradycardia in pregnant women undergoing cesarean section.