Haemodynamic Variability in Obstetric Patients Receiving Spinal Anaesthesia for Caesarean Section: A Comparative Analysis of the Effect of Prophylactic Administration of Ondansetron and Placebo.
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Abstract
Background: Ondansetron suppresses the Bezold Jarisch reflex and has been postulated to be a therapeutic strategy for spinal-induced hypotension in obstetric patients for Caesarean section. The study is aimed at evaluating the effect of prophylactic ondansetron on spinal-induced hypotension in pregnant women scheduled for Caesarean section.
Methodology: Eligible patients were randomized to receive 4mg Ondansetron diluted to 5ml (Group O, n=39) and 5ml of normal saline (Group C, (n=39) 5mins before spinal anaesthesia respectively. The arterial blood pressure, intraoperative vasopressor consumed, incidence of spinal-induced hypotension, bradycardia, side effects like nausea, vomiting, shivering were assessed and recorded. Data was collected and analysed using SPSS 25 for Windows. Numerical data was analysed using an unpaired student t-test, while Categorical data was analysed using the chi-squared test. A p-value < 0.05 was considered significant.
Results: There was a significant decrease in mean HR between group O (99.8±14.7) and group C (91.0±14.5) within 5 minutes of SAB. The reduction in mean MAP was significant (p=0.04) at the 20th minute between the groups. Total ephedrine and glycopyrrolate consumed were significantly lower in group O (0.8±3.6; 0.07±0.1)mg than in group C (12.6±10.2; 0.14±0.1)mg, respectively. The incidence of nausea, vomiting, and shivering was significantly lower in group O (15.8%; 2.6%; 10.5%) than in group C (41.0%; 20.5%; 51.3%) respectively.
Conclusion: Prophylactic ondansetron significantly reduced haemodynamic depression, incidence of nausea, vomiting, and shivering as well as total vasopressor consumption in obstetric patients undergoing Caesarean section under SAB.
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