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

No Thumbnail Available



Journal Title

Journal ISSN

Volume Title


Addis Abeba University


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.



Prophylactic Ondansetron,Spinal anesthesia,hypotension