Jsmc-10298

PREOPERATIVE INTRAVENOUS ONDANSETRON VERSUS EPHEDRINE FOR INTRAOPERATIVE HEMODYNAMIC STABILITY IN CESAREAN SECTION UNDER SPINAL ANESTHESIA

Awan Mohammed-Amin Baram a, Saman Abdula Ahmed Fahmi b, and Amir Murad Khudadad Boujan c 

a  Kurdistan Board of Medical Specialties, Ministry of Health, Kurdistan Region, Iraq.

b Anesthesia Department, Maternity Teaching Hospital, Ministry of Health, Kurdistan Region, Iraq.

c Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

Submitted: 27/6/2020; Accepted: 22/11/2020; Published: 21/6/2021

DOI Link: https://doi.org/10.17656/jsmc.10298 

ABSTRACT

Background 

Intra-operative hypotension is a common complication after spinal anesthesia for cesarean section due to sympathetic block and pooling of blood in the lower limbs by the effect of local anesthetic agent, this complication could be problematic for both the anesthesiologist and the surgeon which may increase perioperative morbidity of the parturient, many preventive measurements had been tried to prevent it but none of them were completely effective

Objectives 

Comparison between intravenous ephedrine and ondansetron for intraoperative hemodynamic stability and frequency of vasopressor use in the cesarean section under spinal anesthesia

Methods

After Kurdistan Board for medical Specialties ethical committee approval a 120 consented parturients involved in this study, they were prepared for cesarean section under spinal anesthesia, ASA=II(American Society of Anesthesiologists physical status II), age between 18-45 year old. They were randomly divided into three groups equally, group (N) received 10ml normal saline; (group E) received 10mg  IV ephedrine ; (group O ) received 8mg IV ondansetron immediately after spinal anesthesia, mean arterial pressure, heart rate, nausea and vomiting monitored perioperatively, Apgar score (Appearance, Pulse, Grimace, Activity, and Respiration) of the fetus and frequency of using vasopressor also recorded.

Results

One hundred twenty (120) term, singletons pregnant patient underwent spinal anesthesia for elective cesarean section included in this study, there was no significant difference found between groups in term of blood pressure but those who received ephedrine have lesser incidence of bradycardia and needs less amount of vasopressor use also ondansetron group has less incidence of bradycardia 

Conclusion

Prophylactic ephedrine or ondansetron is given for spinal anesthesia in elective cesarean delivery have no significant effect on maternal blood pressure, ephedrine reduced the number of patients who require vasoconstrictor and atropine, ondansetron reduces the need for atropine during operation.

KEYWORDS

Ondansetron, Ephedrine, Hemodynamic stability, Spinal anesthesia, Cesarean section.

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