Spinal Hypotension in Women Undergoing Elective Caesarean Section after Spinal Anaesthesia with and without Prophylactic Ondansetron

Abstract

Background: Spinal hypotension is a frequent complication of spinal anesthesia in females during caesarean section. It can result
in adverse perinatal outcomes such as maternal nausea and vomiting, fetal acidosis and is an important contributory factor in
maternal mortality related to regional anesthesia.
Objective: To compare the frequency of spinal hypotension following spinal anaesthesia in women undergoing elective caesarean
section with and without prophylactic ondansetron with reference to the baseline characteristics.
Material and Methods: This comparative randomized trail included 100 pregnant women aged between 18-35 years (means
26.50 + 5 years) undergoing elective cesarean section under spinal anesthesia. These patients were randomly divided into two
groups. In Group-A conventional pre-operative treatment whereas to Group-B received additional dose of 4mg prophylactic
ondansetron. This research was jointly conducted from February, 2017 to August, 2017 at department of Anesthesia, Arif Memorial
Teaching Hospital, affiliated with Rashid Latif Medical College and Lahore General Hospital, Lahore.
2 Results: The BMI of the patients was 27.93±4.45 Kg/m . Mean baseline systolic blood pressure of the patients was 119.13±10.57
mmHg. The frequency of hypotension was significantly lower in patients who received prophylactic ondansetron (34.0% vs. 64.0%;
p=0.003) as compared to controls. Similar differences were observed regardless of age, BMI and baseline systolic blood pressure
groups.
Conclusion: Prophylactic ondansetron significantly reduced the frequency of spinal hypotension in women undergoing elective
cesarean section under spinal anesthesia which favors its routine use in future practice.