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Prophylactic Effects of Ephedrine, Ondansetron and Ringer on Hemodynamic Changes during Cesarean Section under Spinal Anesthesia - a randomized clinical trial.
Ginekol Pol 2018; 89(8):453-58GP

Abstract

BACKGROUND

Hemodynamic change during spinal anaesthesia for cesarean section is prevalent.

OBJECTIVE

Comparing the prophylactic effects of ephedrine, ondansetron and ringer on hemodynamic changes in patients undergoing cesarean section with spinal anaesthesia.

MATERIAL AND METHODS

This randomized clinical trial was carried out on pregnant women undergoing elective cesarean sec-tion referred to teaching hospitals of Mashhad, Iran. Patients allocated to three groups of intravenous ondansetron (O) (4 mg, 5 min),intramuscular ephedrine (E) (25 mg, 25 min) and ringer (R) (500 ml, 20 min) prior to spinal anaesthesia. Anaesthesia inducted with 10-15 mg of bupivacaine. Vital signs were recorded every 3 minutes for 18 minutes including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse rate (PR), pulse oximetry (SpO₂).

RESULTS

Ninety patients with a mean age of 29.4 ± 5.4 years were studied in three groups of O (n = 30), E (n = 30), R (n = 30). Results showed a statistically significant difference in the incidence rate of hypotension 12 minutes after spinal anaesthesia in the three groups, but no statistically significant difference was found in the rest of minutes among the three groups. Dur-ing follow-up minutes, bradycardia was observed in only one patient (1.1%) of Group O and no cases of this sign were observed in other minutes and other groups.

CONCLUSION

Intramuscular administration of ephedrine 25 minutes prior to the spinal anaesthesia leads to better prevention of systolic blood pressure changes compared with intravenous ondansetron and ringer, while administration of ondansetron and ringer had the same effects on reducing hemodynamic changes.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availablemashad university of medical sciences, Iran, Islamic Republic Of. jahanbinz_fatima@yahoo.com.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30215466

Citation

Ranjbar, Mohsen Sabermoghaddam, et al. "Prophylactic Effects of Ephedrine, Ondansetron and Ringer On Hemodynamic Changes During Cesarean Section Under Spinal Anesthesia - a Randomized Clinical Trial." Ginekologia Polska, vol. 89, no. 8, 2018, pp. 453-58.
Ranjbar MS, Sheybani S, Jahanbin F. Prophylactic Effects of Ephedrine, Ondansetron and Ringer on Hemodynamic Changes during Cesarean Section under Spinal Anesthesia - a randomized clinical trial. Ginekol Pol. 2018;89(8):453-58.
Ranjbar, M. S., Sheybani, S., & Jahanbin, F. (2018). Prophylactic Effects of Ephedrine, Ondansetron and Ringer on Hemodynamic Changes during Cesarean Section under Spinal Anesthesia - a randomized clinical trial. Ginekologia Polska, 89(8), pp. 453-58. doi:10.5603/GP.a2018.0078.
Ranjbar MS, Sheybani S, Jahanbin F. Prophylactic Effects of Ephedrine, Ondansetron and Ringer On Hemodynamic Changes During Cesarean Section Under Spinal Anesthesia - a Randomized Clinical Trial. Ginekol Pol. 2018;89(8):453-58. PubMed PMID: 30215466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic Effects of Ephedrine, Ondansetron and Ringer on Hemodynamic Changes during Cesarean Section under Spinal Anesthesia - a randomized clinical trial. AU - Ranjbar,Mohsen Sabermoghaddam, AU - Sheybani,Shima, AU - Jahanbin,Fatemeh, PY - 2018/05/06/received PY - 2018/06/12/accepted PY - 2018/9/15/entrez PY - 2018/9/15/pubmed PY - 2019/4/23/medline KW - cesarean section KW - ephedrine KW - hemodynamic changes KW - ondansetron KW - ringer KW - spinal anesthesia SP - 453 EP - 58 JF - Ginekologia polska JO - Ginekol. Pol. VL - 89 IS - 8 N2 - BACKGROUND: Hemodynamic change during spinal anaesthesia for cesarean section is prevalent. OBJECTIVE: Comparing the prophylactic effects of ephedrine, ondansetron and ringer on hemodynamic changes in patients undergoing cesarean section with spinal anaesthesia. MATERIAL AND METHODS: This randomized clinical trial was carried out on pregnant women undergoing elective cesarean sec-tion referred to teaching hospitals of Mashhad, Iran. Patients allocated to three groups of intravenous ondansetron (O) (4 mg, 5 min),intramuscular ephedrine (E) (25 mg, 25 min) and ringer (R) (500 ml, 20 min) prior to spinal anaesthesia. Anaesthesia inducted with 10-15 mg of bupivacaine. Vital signs were recorded every 3 minutes for 18 minutes including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse rate (PR), pulse oximetry (SpO₂). RESULTS: Ninety patients with a mean age of 29.4 ± 5.4 years were studied in three groups of O (n = 30), E (n = 30), R (n = 30). Results showed a statistically significant difference in the incidence rate of hypotension 12 minutes after spinal anaesthesia in the three groups, but no statistically significant difference was found in the rest of minutes among the three groups. Dur-ing follow-up minutes, bradycardia was observed in only one patient (1.1%) of Group O and no cases of this sign were observed in other minutes and other groups. CONCLUSION: Intramuscular administration of ephedrine 25 minutes prior to the spinal anaesthesia leads to better prevention of systolic blood pressure changes compared with intravenous ondansetron and ringer, while administration of ondansetron and ringer had the same effects on reducing hemodynamic changes. SN - 0017-0011 UR - https://www.unboundmedicine.com/medline/citation/30215466/Prophylactic_Effects_of_Ephedrine_Ondansetron_and_Ringer_on_Hemodynamic_Changes_during_Cesarean_Section_under_Spinal_Anesthesia___a_randomized_clinical_trial_ L2 - https://medlineplus.gov/cesareansection.html DB - PRIME DP - Unbound Medicine ER -