Tags

Type your tag names separated by a space and hit enter

Ephedrine versus ondansetron in the prevention of hypotension during cesarean delivery: a randomized, double-blind, placebo-controlled trial.
Int J Obstet Anesth 2016; 27:25-31IJ

Abstract

BACKGROUND

Maternal hypotension is common after spinal anesthesia for cesarean delivery. We compared the effects of prophylactic ephedrine with ondansetron on post-spinal blood pressure.

METHODS

One hundred and sixty-eight term, singleton parturients were enrolled in this prospective, double-blind, placebo-controlled trial. Patients were randomized to receive either prophylactic intravenous ephedrine 10mg (Group E), ondansetron 8mg (Group O) or normal saline (Group P) immediately after spinal anesthesia. The primary outcome was maternal blood pressure between spinal block and delivery; secondary outcomes were nausea and vomiting scores, Apgar scores, numbers requiring intraoperative vasoconstrictors and the dose of vasoconstrictors required.

RESULTS

Fifty-six patients were recruited to each group, but two in Group P were excluded from the analysis owing to protocol violations. There were no significant differences between the groups in maternal systolic, diastolic or mean arterial pressures, or the proportion of patients experiencing hypotension. The proportion of patients in Group E requiring intraoperative ephedrine or any vasoconstrictor (ephedrine and/or norepinephrine) was significantly lower than that in Group P (P=0.023 and 0.034, respectively). The proportion of patients in Group O requiring intraoperative norepinephrine was significantly lower than that in Group P (P=0.02). There was no difference in the proportions of patients in Groups E and O requiring any vasoconstrictors (P=0.34).

CONCLUSIONS

There was no significant difference in maternal blood pressure in women administered prophylactic ephedrine or ondansetron after spinal anesthesia for cesarean delivery compared with placebo. Ephedrine reduced the proportion of patients requiring a rescue vasoconstrictor before delivery.

Authors+Show Affiliations

Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: patchareya.niv@mahidol.ac.th.Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27020487

Citation

Nivatpumin, P, and V Thamvittayakul. "Ephedrine Versus Ondansetron in the Prevention of Hypotension During Cesarean Delivery: a Randomized, Double-blind, Placebo-controlled Trial." International Journal of Obstetric Anesthesia, vol. 27, 2016, pp. 25-31.
Nivatpumin P, Thamvittayakul V. Ephedrine versus ondansetron in the prevention of hypotension during cesarean delivery: a randomized, double-blind, placebo-controlled trial. Int J Obstet Anesth. 2016;27:25-31.
Nivatpumin, P., & Thamvittayakul, V. (2016). Ephedrine versus ondansetron in the prevention of hypotension during cesarean delivery: a randomized, double-blind, placebo-controlled trial. International Journal of Obstetric Anesthesia, 27, pp. 25-31. doi:10.1016/j.ijoa.2016.02.003.
Nivatpumin P, Thamvittayakul V. Ephedrine Versus Ondansetron in the Prevention of Hypotension During Cesarean Delivery: a Randomized, Double-blind, Placebo-controlled Trial. Int J Obstet Anesth. 2016;27:25-31. PubMed PMID: 27020487.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ephedrine versus ondansetron in the prevention of hypotension during cesarean delivery: a randomized, double-blind, placebo-controlled trial. AU - Nivatpumin,P, AU - Thamvittayakul,V, Y1 - 2016/02/21/ PY - 2015/07/29/received PY - 2016/01/29/revised PY - 2016/02/13/accepted PY - 2016/3/30/entrez PY - 2016/3/30/pubmed PY - 2017/9/20/medline KW - Anesthesia KW - Cesarean delivery KW - Ephedrine KW - Hypotension KW - Ondansetron KW - Spinal SP - 25 EP - 31 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 27 N2 - BACKGROUND: Maternal hypotension is common after spinal anesthesia for cesarean delivery. We compared the effects of prophylactic ephedrine with ondansetron on post-spinal blood pressure. METHODS: One hundred and sixty-eight term, singleton parturients were enrolled in this prospective, double-blind, placebo-controlled trial. Patients were randomized to receive either prophylactic intravenous ephedrine 10mg (Group E), ondansetron 8mg (Group O) or normal saline (Group P) immediately after spinal anesthesia. The primary outcome was maternal blood pressure between spinal block and delivery; secondary outcomes were nausea and vomiting scores, Apgar scores, numbers requiring intraoperative vasoconstrictors and the dose of vasoconstrictors required. RESULTS: Fifty-six patients were recruited to each group, but two in Group P were excluded from the analysis owing to protocol violations. There were no significant differences between the groups in maternal systolic, diastolic or mean arterial pressures, or the proportion of patients experiencing hypotension. The proportion of patients in Group E requiring intraoperative ephedrine or any vasoconstrictor (ephedrine and/or norepinephrine) was significantly lower than that in Group P (P=0.023 and 0.034, respectively). The proportion of patients in Group O requiring intraoperative norepinephrine was significantly lower than that in Group P (P=0.02). There was no difference in the proportions of patients in Groups E and O requiring any vasoconstrictors (P=0.34). CONCLUSIONS: There was no significant difference in maternal blood pressure in women administered prophylactic ephedrine or ondansetron after spinal anesthesia for cesarean delivery compared with placebo. Ephedrine reduced the proportion of patients requiring a rescue vasoconstrictor before delivery. SN - 1532-3374 UR - https://www.unboundmedicine.com/medline/citation/27020487/Ephedrine_versus_ondansetron_in_the_prevention_of_hypotension_during_cesarean_delivery:_a_randomized_double_blind_placebo_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(16)00032-7 DB - PRIME DP - Unbound Medicine ER -