Preemptive administration of ondansetron and phenylephrine for prevention of perioperative hypotension under spinal anesthesia for cesarean section: a quasi-experimental study
Keywords:
Cesarean section, Hypotension, Ondansetron, PhenylephrineAbstract
Background: Hypotension is the most commonly observed complications with the reported prevalence upto 90% without prophylaxis after spinal anesthesia in obstetric cases. Various methods have been implemented to mitigate spinal induced hypotension. Pharmacological agents as pure α2 adrenoceptor agonist as phenylephrine and 5HT3 antagonists as ondansetron have been used to prevent and treat spinal anesthesia induced hypotension. We aimed to find out whether or not pre-emptive administration of phenylephrine or ondansetron attenuates hypotension in elective cesarean section in healthy parturient under spinal anesthesia.
Methods: This quasi-experimental study was conducted in 120 ASA II parturient scheduled for elective cesarean section under spinal anesthesia with 10 mg 0.5% heavy bupivacaine. Patients in Group O received 4 mg ondansetron and patients in Group P received 100 µg phenylephrine immediately after spinal anesthesia. The occurrence of hypotension, total requirement of mephentermine was compared in both the groups. The complications such as bradycardia, nausea, vomiting were also compared.
Results: Hypotension was present in 31 patients in Group O (51.67%) and 33 patients in Group P (55%) (p=0.71). Consumption of mephentermine were comparable in both the groups (p=0.67) Bradycardia was not seen in any patients of Group O. It was present in five patients in Group P (8.33%) (p=0.02) which was treated with atropine. There were no cases of severe nausea and vomiting requiring treatment in any of the groups.
Conclusions: The pre-emptive administration of phenylephrine or ondansetron was not useful in attenuating intraoperative hypotension in healthy parturient undergoing elective cesarean section under spinal anesthesia.
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