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Comparing Two Different Doses of Intravenous Ondansetron With Placebo on Attenuation of Spinal-induced Hypotension and Shivering.
Anesth Pain Med 2014; 4(2):e12055AP

Abstract

BACKGROUND

Side effects of spinal anesthesia are hypotension, bradycardia and shivering. Five-hydroxytriptamine (5-HT), a serotonergic receptor, may be an important factor associated with inducing the Bezold Jarish reflex (BJR) that may lead to the bradycardia and hypotension in the setting of decreased blood volume.

OBJECTIVES

This study aimed to investigate the effect of intravenous administration of ondansetron, a 5-HT3 receptor antagonist, which could attenuate spinal-induced hypotension, bradycardia and shivering.

PATIENTS AND METHODS

Two hundred and ten patients aged 20-50 years old were scheduled for spinal anesthesia and were divided randomly into three equal groups. The control group received normal saline and intervention groups received 6 mg or 12 mg of intravenous ondansetron 5 minutes before spinal anesthesia. Mean arterial pressure (MAP), heart rate (HR), and shivering were recorded before and after spinal anesthesia every 5 minutes during first 20 minutes of surgery.

RESULTS

Demographic data were not statistically different among groups. HR was statistically different between the experimental groups and the control group. Ten patients (14%) in the control group had HR < 50 bpm, that required intravenous atropine compared to experimental groups (P =0.02). In the control group 12 (17%) patients had MAP < 80 mm Hg and required vasopressors compared to experimental groups (P = 0.04). There were no significant differences in MAP and HR between the experimental groups (P =0.06). Incidence of shivering in the control group was 45% (32.70) that was statistically more than experimental groups (P = 0.02).

CONCLUSIONS

Administration of two different doses of intravenous ondansetron, 6 mg and 12 mg, significantly attenuates spinal induced hypotension, bradycardia and shivering compared to the control saline group. However, the hemodynamic profiles and shivering in experimental groups were not statistically different.

Authors+Show Affiliations

Department of Anesthesiology, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of Anesthesiology, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24790900

Citation

Marashi, Seyed Mojtaba, et al. "Comparing Two Different Doses of Intravenous Ondansetron With Placebo On Attenuation of Spinal-induced Hypotension and Shivering." Anesthesiology and Pain Medicine, vol. 4, no. 2, 2014, pp. e12055.
Marashi SM, Soltani-Omid S, Soltani Mohammadi S, et al. Comparing Two Different Doses of Intravenous Ondansetron With Placebo on Attenuation of Spinal-induced Hypotension and Shivering. Anesth Pain Med. 2014;4(2):e12055.
Marashi, S. M., Soltani-Omid, S., Soltani Mohammadi, S., Aghajani, Y., & Movafegh, A. (2014). Comparing Two Different Doses of Intravenous Ondansetron With Placebo on Attenuation of Spinal-induced Hypotension and Shivering. Anesthesiology and Pain Medicine, 4(2), pp. e12055. doi:10.5812/aapm.12055.
Marashi SM, et al. Comparing Two Different Doses of Intravenous Ondansetron With Placebo On Attenuation of Spinal-induced Hypotension and Shivering. Anesth Pain Med. 2014;4(2):e12055. PubMed PMID: 24790900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing Two Different Doses of Intravenous Ondansetron With Placebo on Attenuation of Spinal-induced Hypotension and Shivering. AU - Marashi,Seyed Mojtaba, AU - Soltani-Omid,Saeid, AU - Soltani Mohammadi,Sussan, AU - Aghajani,Yasaman, AU - Movafegh,Ali, Y1 - 2014/03/18/ PY - 2013/05/15/received PY - 2013/06/24/revised PY - 2013/08/06/accepted PY - 2014/5/3/entrez PY - 2014/5/3/pubmed PY - 2014/5/3/medline KW - Anesthesia, Spinal KW - Arterial Pressure KW - Heart Rate KW - Hypotension KW - Ondansetron KW - Serotonin SP - e12055 EP - e12055 JF - Anesthesiology and pain medicine JO - Anesth Pain Med VL - 4 IS - 2 N2 - BACKGROUND: Side effects of spinal anesthesia are hypotension, bradycardia and shivering. Five-hydroxytriptamine (5-HT), a serotonergic receptor, may be an important factor associated with inducing the Bezold Jarish reflex (BJR) that may lead to the bradycardia and hypotension in the setting of decreased blood volume. OBJECTIVES: This study aimed to investigate the effect of intravenous administration of ondansetron, a 5-HT3 receptor antagonist, which could attenuate spinal-induced hypotension, bradycardia and shivering. PATIENTS AND METHODS: Two hundred and ten patients aged 20-50 years old were scheduled for spinal anesthesia and were divided randomly into three equal groups. The control group received normal saline and intervention groups received 6 mg or 12 mg of intravenous ondansetron 5 minutes before spinal anesthesia. Mean arterial pressure (MAP), heart rate (HR), and shivering were recorded before and after spinal anesthesia every 5 minutes during first 20 minutes of surgery. RESULTS: Demographic data were not statistically different among groups. HR was statistically different between the experimental groups and the control group. Ten patients (14%) in the control group had HR < 50 bpm, that required intravenous atropine compared to experimental groups (P =0.02). In the control group 12 (17%) patients had MAP < 80 mm Hg and required vasopressors compared to experimental groups (P = 0.04). There were no significant differences in MAP and HR between the experimental groups (P =0.06). Incidence of shivering in the control group was 45% (32.70) that was statistically more than experimental groups (P = 0.02). CONCLUSIONS: Administration of two different doses of intravenous ondansetron, 6 mg and 12 mg, significantly attenuates spinal induced hypotension, bradycardia and shivering compared to the control saline group. However, the hemodynamic profiles and shivering in experimental groups were not statistically different. SN - 2228-7523 UR - https://www.unboundmedicine.com/medline/citation/24790900/Comparing_Two_Different_Doses_of_Intravenous_Ondansetron_With_Placebo_on_Attenuation_of_Spinal_induced_Hypotension_and_Shivering_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24790900/ DB - PRIME DP - Unbound Medicine ER -