Evaluation of the efficacy of intravenous ondansetron in comparison to ondansetron with dexamethasone for prevention of spinal anesthesia-induced hypotension in patients posted for infraumbilical surgeries – A prospective randomized double-blind study
Background and Aims: Spinal anesthesia is the preferred technique for infraumbilical surgeries. However, its association with complications such as hypotension (33%–80%) and bradycardia (13%) mandates caution in the perioperative period. This study aimed to compare the efficacy of ondansetron versus...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | The Indian Anaesthetists' Forum |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/TheIAForum.TheIAForum_5_25 |
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| Summary: | Background and Aims:
Spinal anesthesia is the preferred technique for infraumbilical surgeries. However, its association with complications such as hypotension (33%–80%) and bradycardia (13%) mandates caution in the perioperative period. This study aimed to compare the efficacy of ondansetron versus ondansetron with dexamethasone in preventing spinal anesthesia-induced hypotension and bradycardia in patients scheduled for non-obstetric infraumbilical surgeries. The time to rescue analgesia, time to two-segment regression, QTc interval changes, and blood glucose levels were examined as secondary objectives.
Materials and Methods:
In this prospective, double-blind, randomized study, 140 patients of the American Society of Anesthesiologists grades I and II, belonging to both sexes, undergoing infraumblical surgeries, were allocated to Group O (ondansetron n = 70) and Group OD (ondansetron and dexamethasone n = 70). After spinal anesthesia, patients’ hemodynamic parameters, including heart rate (HR); systolic, diastolic, and mean blood pressure; and SPO2, were noted every 3 min till 15 min and then every 5 min till 60 min or the end of surgery. Continuous measurements were presented as mean ± standard deviation, and categorical measurements were presented as numbers (%). The Student’s t-test was used to determine the significance of the study parameters on a continuous scale between the two groups.
Results:
HR, mean arterial pressure, and the requirement for mephentermine and atropine injections were comparable between the two groups. Rescue analgesic requirement was earlier in Group O, at 127.33 ± 37.229 min versus 219.58 ± 73.9 min in Group OD, indicating prolonged postoperative analgesic action (P ≤ 0.001). Higher blood glucose levels were observed 4 h after spinal anesthesia in Group OD (122 ± 25.43 mg/dL) than in Group O (108.13 ± 15.13 mg/dL), with a P < 0.001.
Conclusion:
Ondansetron, both as an individual molecule and combined with dexamethasone, effectively reduced the incidence of postspinal hypotension. |
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| ISSN: | 0973-0311 |