Prophylactic ondansetron for prevention of maternal hypotension following spinal anesthesia in women undergoing cesarean section: a systematic review protocol.

Abstract

REVIEW QUESTION / OBJECTIVE The objective of this review is to synthesize the best available evidence on the effectiveness of ondansetron given prophylactically prior to spinal anesthesia on attenuating hypotension in women undergoing elective cesarean section. The specific review question is as follows: In women undergoing spinal anesthesia for elective cesarean section, what is the effectiveness of prophylactic ondansetron on preventing hypotension, compared to placebo? INCLUSION CRITERIA Types of participants The review will consider all quantitative studies that include parturients, of any ethnicity, undergoing spinal anesthesia for elective cesarean delivery. Studies that focus on any other surgeries other than cesarean section and anesthesia modes other than spinal anesthesia (general anesthesia or epidural anesthesia) will be excluded. Furthermore, any study with parturients not undergoing cesarean section or undergoing emergent cesarean section will also be omitted. Lastly, it is important to exclude studies that include subjects with hypertensive disorders of pregnancy, because this population may meet hypotension criteria less frequently. Types of intervention(s)/phenomena of interest This review will only consider studies of ondansetron administered intravenously for the prevention of hypotension in subjects requiring spinal anesthesia for elective cesarean section. More precisely, the goal of this review is to identify if prophylactic administration of ondansetron is more effective than a placebo in preventing hypotension after spinal anesthesia. All variations of ondansetron dosages and their duration of administration will be included. Differences in anesthetic technique across studies, including the variations in armamentarium and dosing strategies are beyond the goal of the review question under inquiry, TRUNCATED AT 250 WORDS