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Effect of ondansetron on prevention of post-induction hypotension in elderly patients undergoing general anesthesia: A randomized, double-blind placebo-controlled clinical trial.
Saudi J Anaesth 2015 Oct-Dec; 9(4):365-9SJ

Abstract

BACKGROUND

Elderly patients are susceptible to post-induction hypotension. Volume loading and vasopressors for prevention of hypotension in elderly patients may increase perioperative cardiovascular risks. Ondansetron by blocking Bezold-Jarisch reflex (BJR) through inhibition of serotonin receptors has been effective in the prevention of post-spinal hypotension, and bradycardia. Bradycardia frequently accompanies post-induction hypotension in elderly patients, which signifies a possible preventing role for ondansetron. No previous study has evaluated the prophylactic effects of ondansetron for the prevention of post-induction hypotension.

MATERIALS AND METHODS

In this randomized placebo-controlled clinical trial, ondansetron 4 mg was given intravenously to 65 elderly patients, 20 min before induction of general anesthesia, and the rate of post-induction hypotension defined as 25% or more reduction in mean arterial blood pressure, compared with a placebo groups.

RESULTS

A total of 114 patients completed the study (58 in ondansetron and 56 in the placebo group). Proportions of post-induction hypotension were 9 (16%) and 25 (45%) in ondansetron and placebo groups, respectively, (P = 0.001). Forty-five patients (40%) developed bradycardia. Rates of bradycardia were not significantly different between two groups.

CONCLUSIONS

The results of this study show the effectiveness of intravenous ondansetron for prevention of post-induction hypotension in elderly patients. The mechanism of this effect largely is unknown. Role of ondansetron for prevention of post-induction hypotension may not fully understandable by its interaction with BJR, as has been shown in post-spinal hypotension.

Authors+Show Affiliations

Department of Anesthesia, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Anesthesia, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Anesthesia, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26543450

Citation

Golparvar, Mohammad, et al. "Effect of Ondansetron On Prevention of Post-induction Hypotension in Elderly Patients Undergoing General Anesthesia: a Randomized, Double-blind Placebo-controlled Clinical Trial." Saudi Journal of Anaesthesia, vol. 9, no. 4, 2015, pp. 365-9.
Golparvar M, Saghaei M, Saadati MA, et al. Effect of ondansetron on prevention of post-induction hypotension in elderly patients undergoing general anesthesia: A randomized, double-blind placebo-controlled clinical trial. Saudi J Anaesth. 2015;9(4):365-9.
Golparvar, M., Saghaei, M., Saadati, M. A., & Farsaei, S. (2015). Effect of ondansetron on prevention of post-induction hypotension in elderly patients undergoing general anesthesia: A randomized, double-blind placebo-controlled clinical trial. Saudi Journal of Anaesthesia, 9(4), pp. 365-9. doi:10.4103/1658-354X.159455.
Golparvar M, et al. Effect of Ondansetron On Prevention of Post-induction Hypotension in Elderly Patients Undergoing General Anesthesia: a Randomized, Double-blind Placebo-controlled Clinical Trial. Saudi J Anaesth. 2015;9(4):365-9. PubMed PMID: 26543450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of ondansetron on prevention of post-induction hypotension in elderly patients undergoing general anesthesia: A randomized, double-blind placebo-controlled clinical trial. AU - Golparvar,Mohammad, AU - Saghaei,Mahmoud, AU - Saadati,Mohammad Ali, AU - Farsaei,Shadi, PY - 2015/11/7/entrez PY - 2015/11/7/pubmed PY - 2015/11/7/medline KW - Elderly patients KW - general anesthesia KW - hypotension KW - ondansetron SP - 365 EP - 9 JF - Saudi journal of anaesthesia JO - Saudi J Anaesth VL - 9 IS - 4 N2 - BACKGROUND: Elderly patients are susceptible to post-induction hypotension. Volume loading and vasopressors for prevention of hypotension in elderly patients may increase perioperative cardiovascular risks. Ondansetron by blocking Bezold-Jarisch reflex (BJR) through inhibition of serotonin receptors has been effective in the prevention of post-spinal hypotension, and bradycardia. Bradycardia frequently accompanies post-induction hypotension in elderly patients, which signifies a possible preventing role for ondansetron. No previous study has evaluated the prophylactic effects of ondansetron for the prevention of post-induction hypotension. MATERIALS AND METHODS: In this randomized placebo-controlled clinical trial, ondansetron 4 mg was given intravenously to 65 elderly patients, 20 min before induction of general anesthesia, and the rate of post-induction hypotension defined as 25% or more reduction in mean arterial blood pressure, compared with a placebo groups. RESULTS: A total of 114 patients completed the study (58 in ondansetron and 56 in the placebo group). Proportions of post-induction hypotension were 9 (16%) and 25 (45%) in ondansetron and placebo groups, respectively, (P = 0.001). Forty-five patients (40%) developed bradycardia. Rates of bradycardia were not significantly different between two groups. CONCLUSIONS: The results of this study show the effectiveness of intravenous ondansetron for prevention of post-induction hypotension in elderly patients. The mechanism of this effect largely is unknown. Role of ondansetron for prevention of post-induction hypotension may not fully understandable by its interaction with BJR, as has been shown in post-spinal hypotension. SN - 1658-354X UR - https://www.unboundmedicine.com/medline/citation/26543450/Effect_of_ondansetron_on_prevention_of_post_induction_hypotension_in_elderly_patients_undergoing_general_anesthesia:_A_randomized_double_blind_placebo_controlled_clinical_trial_ L2 - http://www.saudija.org/article.asp?issn=1658-354X;year=2015;volume=9;issue=4;spage=365;epage=369;aulast=Golparvar DB - PRIME DP - Unbound Medicine ER -