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The effect of intravenous ondansetron on maternal haemodynamics during elective caesarean delivery under spinal anaesthesia: a double-blind, randomised, placebo-controlled trial.
Int J Obstet Anesth 2014; 23(2):138-43IJ

Abstract

BACKGROUND

Spinal anaesthesia for caesarean delivery is frequently associated with adverse effects such as maternal hypotension and bradycardia. Prophylactic administration of ondansetron has been reported to provide a protective effect. We studied the effect of different doses of ondansetron in obstetric patients.

METHODS

This prospective double-blind, randomised, placebo-controlled study included 128 healthy pregnant women scheduled for elective caesarean delivery under spinal anaesthesia. Women were randomly allocated into four groups (n=32) to receive either placebo or ondansetron 2, 4 or 8 mg intravenously before induction of spinal anaesthesia. Demographic, obstetric, intraoperative timing and anaesthetic variables were assessed at 16 time points. Anaesthetic variables assessed included blood pressure, heart rate, oxygen saturation, nausea, vomiting, electrocardiographic changes, skin flushing, discomfort or pruritus and vasopressor requirements.

RESULTS

There were no differences in the number of patients with hypotension in the placebo (43.8%) and ondansetron 2mg (53.1%), 4 mg (56.3%) and 8 mg (53.1%) groups (P=0.77), nor the percentage of time points with systolic hypotension (7.3% in the placebo group and 11.1%, 15.7% and 12.6% in the ondansetron 2, 4 and 8 mg groups, respectively, P=0.32). There were no differences between groups in ephedrine (P=0.11) or phenylephrine (P=0.89) requirements and the number of patients with adverse effects.

CONCLUSIONS

In our study, prophylactic ondansetron had little effect on the incidence of hypotension in healthy parturients undergoing spinal anaesthesia with bupivacaine and fentanyl for elective caesarean delivery.

Authors+Show Affiliations

Department of Anaesthesiology, Hospital Virgen del Camino, Pamplona, Spain. Electronic address: j.r.ortiz.gomez.md.phd@gmail.com.Department of Anaesthesiology, Hospital Gregorio Marañón, Madrid, Spain.Department of Anaesthesiology, Hospital Gregorio Marañón, Madrid, Spain.Department of Anaesthesiology, Hospital Puerta de Hierro, Madrid, Spain.Department of Anaesthesiology, Hospital Gregorio Marañón, Madrid, Spain.Department of Anaesthesiology, Hospital Gregorio Marañón, Madrid, Spain.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24631057

Citation

Ortiz-Gómez, J R., et al. "The Effect of Intravenous Ondansetron On Maternal Haemodynamics During Elective Caesarean Delivery Under Spinal Anaesthesia: a Double-blind, Randomised, Placebo-controlled Trial." International Journal of Obstetric Anesthesia, vol. 23, no. 2, 2014, pp. 138-43.
Ortiz-Gómez JR, Palacio-Abizanda FJ, Morillas-Ramirez F, et al. The effect of intravenous ondansetron on maternal haemodynamics during elective caesarean delivery under spinal anaesthesia: a double-blind, randomised, placebo-controlled trial. Int J Obstet Anesth. 2014;23(2):138-43.
Ortiz-Gómez, J. R., Palacio-Abizanda, F. J., Morillas-Ramirez, F., Fornet-Ruiz, I., Lorenzo-Jiménez, A., & Bermejo-Albares, M. L. (2014). The effect of intravenous ondansetron on maternal haemodynamics during elective caesarean delivery under spinal anaesthesia: a double-blind, randomised, placebo-controlled trial. International Journal of Obstetric Anesthesia, 23(2), pp. 138-43. doi:10.1016/j.ijoa.2014.01.005.
Ortiz-Gómez JR, et al. The Effect of Intravenous Ondansetron On Maternal Haemodynamics During Elective Caesarean Delivery Under Spinal Anaesthesia: a Double-blind, Randomised, Placebo-controlled Trial. Int J Obstet Anesth. 2014;23(2):138-43. PubMed PMID: 24631057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of intravenous ondansetron on maternal haemodynamics during elective caesarean delivery under spinal anaesthesia: a double-blind, randomised, placebo-controlled trial. AU - Ortiz-Gómez,J R, AU - Palacio-Abizanda,F J, AU - Morillas-Ramirez,F, AU - Fornet-Ruiz,I, AU - Lorenzo-Jiménez,A, AU - Bermejo-Albares,M L, Y1 - 2014/02/04/ PY - 2013/01/27/received PY - 2014/01/20/revised PY - 2014/01/25/accepted PY - 2014/3/18/entrez PY - 2014/3/19/pubmed PY - 2014/12/15/medline KW - Caesarean delivery KW - Hypotension KW - Ondansetron KW - Spinal anaesthesia SP - 138 EP - 43 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 23 IS - 2 N2 - BACKGROUND: Spinal anaesthesia for caesarean delivery is frequently associated with adverse effects such as maternal hypotension and bradycardia. Prophylactic administration of ondansetron has been reported to provide a protective effect. We studied the effect of different doses of ondansetron in obstetric patients. METHODS: This prospective double-blind, randomised, placebo-controlled study included 128 healthy pregnant women scheduled for elective caesarean delivery under spinal anaesthesia. Women were randomly allocated into four groups (n=32) to receive either placebo or ondansetron 2, 4 or 8 mg intravenously before induction of spinal anaesthesia. Demographic, obstetric, intraoperative timing and anaesthetic variables were assessed at 16 time points. Anaesthetic variables assessed included blood pressure, heart rate, oxygen saturation, nausea, vomiting, electrocardiographic changes, skin flushing, discomfort or pruritus and vasopressor requirements. RESULTS: There were no differences in the number of patients with hypotension in the placebo (43.8%) and ondansetron 2mg (53.1%), 4 mg (56.3%) and 8 mg (53.1%) groups (P=0.77), nor the percentage of time points with systolic hypotension (7.3% in the placebo group and 11.1%, 15.7% and 12.6% in the ondansetron 2, 4 and 8 mg groups, respectively, P=0.32). There were no differences between groups in ephedrine (P=0.11) or phenylephrine (P=0.89) requirements and the number of patients with adverse effects. CONCLUSIONS: In our study, prophylactic ondansetron had little effect on the incidence of hypotension in healthy parturients undergoing spinal anaesthesia with bupivacaine and fentanyl for elective caesarean delivery. SN - 1532-3374 UR - https://www.unboundmedicine.com/medline/citation/24631057/The_effect_of_intravenous_ondansetron_on_maternal_haemodynamics_during_elective_caesarean_delivery_under_spinal_anaesthesia:_a_double_blind_randomised_placebo_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(14)00027-2 DB - PRIME DP - Unbound Medicine ER -