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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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | The Indian Anaesthetists' Forum |
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| Online Access: | https://journals.lww.com/10.4103/TheIAForum.TheIAForum_5_25 |
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| author | Ananya Nanda Supraja Ponduru Vandana Patilbuwa Pakhare R. Gopinath Vamshidhar Malipeddi Vyshnavi Renganathan |
| author_facet | Ananya Nanda Supraja Ponduru Vandana Patilbuwa Pakhare R. Gopinath Vamshidhar Malipeddi Vyshnavi Renganathan |
| author_sort | Ananya Nanda |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-9a98414217fb4ecfb4064ad45788c5ec |
| institution | Kabale University |
| issn | 0973-0311 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Indian Anaesthetists' Forum |
| spelling | doaj-art-9a98414217fb4ecfb4064ad45788c5ec2025-08-20T03:29:18ZengWolters Kluwer Medknow PublicationsThe Indian Anaesthetists' Forum0973-03112025-01-01261424810.4103/TheIAForum.TheIAForum_5_25Evaluation 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 studyAnanya NandaSupraja PonduruVandana Patilbuwa PakhareR. GopinathVamshidhar MalipeddiVyshnavi RenganathanBackground 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.https://journals.lww.com/10.4103/TheIAForum.TheIAForum_5_255-ht3 receptorsbradycardiadexamethasonehypotensionondansetronspinal anesthesia |
| spellingShingle | Ananya Nanda Supraja Ponduru Vandana Patilbuwa Pakhare R. Gopinath Vamshidhar Malipeddi Vyshnavi Renganathan 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 The Indian Anaesthetists' Forum 5-ht3 receptors bradycardia dexamethasone hypotension ondansetron spinal anesthesia |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | 5-ht3 receptors bradycardia dexamethasone hypotension ondansetron spinal anesthesia |
| url | https://journals.lww.com/10.4103/TheIAForum.TheIAForum_5_25 |
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