Effect of prophylactic Ondansetron on prevention of spinal anesthesia induced hypotension among women undergoing elective cesarean section at Yekatit-12 hospital, Ethiopia, 2019: Prospective cohort study
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Date
2020-06
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Addis Abeba University
Abstract
Background: Hypotension is a common side effects after spinal anesthesia which associate with
both maternal and fetal morbidity. Many interventions have been suggested to prevent this
clinical problem. A commonly used antiemetic, ondansetron, can be used as an alternative to
prevent hypotension after spinal anesthesia. The action believed to inhibit Bezold-Jarisch reflex.
Objective: To assess effect of prophylactic ondansetron on spinal anesthesia induced
hypotension among women undergoing elective cesarean section at yekatit-12 hospital, from
Oct, 2019 –Jan, 2020, Addis Ababa, Ethiopia.
Methodology: In this prospective cohort study 100 patients with American Society of
Anesthesiologists (ASA) status class-II, age≥18 and BMI 18 -30 kg/m2 who underwent cesarean
section under spinal anesthesia were included. Prophylactic group (n=50) receive 4mg
ondansetron, while Non-prophylactic group (n=50) did not receive ondansetron. The outcomes
of the study were the incidence of hypotension, nausea, vomiting and the need of rescue
vasopressor. Comparisons of variables between study groups were done using student t test and
Chi square test. Significance was determined at P value <0.05. Table and graph were used to
show result of the study.
Result: The incidence of hypotension is 13(26.5%) in prophylactic group compared to non-
prophylactic group 36(75% with (p=007). There was a statistically significant difference in mean
systolic blood pressure, mean heart rate and mean arterial pressure between the groups at all-time
point with p<0.05. The incidence of nausea and vomiting was higher in non-prophylactic group
when compared with prophylactic group with (p=0.003 & 0.001) respectively. There was not
significant difference in total need of rescue vasopressor between groups (6.1% in prophylactic
and 10.4% in non-prophylactic group with (p=0.17).
Conclusion and Recommendation: prophylactic use of 4mg intravenous ondansetron 5 minutes
before spinal anesthesia significantly reduces the incidence of hypotension; nausea and vomiting
in parturient undergoing elective cesarean section. We recommend the use prophylaxis
ondansetron for prevention of spinal anesthesia induced hypotension in parturient undergo
elective cesarean section under spinal anesthesia.
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Keywords
Prophylactic Ondansetron,Spinal anesthesia,hypotension