Granisetron or ondansentron to prevent hypotension after spinal anesthesia for elective cesarean delivery: A randomized placebo-controlled trial.

Abstract

STUDY OBJECTIVE\nThis study aimed to compare the effects of high doses of ondansetron and granisetron before spinal anesthesia on hemodynamic parameters in patients undergoing elective cesarean section.\n\n\nDESIGN\nA double-blinded randomized placebo-controlled trial.\n\n\nSETTING\nOperating room.\n\n\nPATIENTS\nA total of 120 parturients with term pregnancy undergoing elective cesarean section with combined spinal-epidural anesthesia were included.\n\n\nINTERVENTIONS\nThree groups (n\xa0=\xa040 for each group) were formed by randomization. Five minutes before the anesthesia procedure, Group I received 8\xa0mg intravenous (IV) ondansetron diluted in 10\xa0ml normal saline, Group II received IV 3\xa0mg granisetron diluted in 10\xa0ml normal saline, and Group III received IV 10\xa0ml normal saline.\n\n\nMEASUREMENTS\nFollowing intrathecal drug administration, intraoperative hemodynamic changes were recorded every 2\xa0min for 20\xa0min and then every 5\xa0min until the end of the operation.\n\n\nMAIN RESULTS\nTwenty patients (50%) in Group I, 12 patients (30%) in Group II, and 29 patients (72.5%) in Group III had hypotension requiring treatment with IV ephedrine (P\xa0=\xa00.001). The ephedrine requirement in Group III was significantly higher than in Groups I (P\xa0=\xa00.033) and II (P\xa0<\xa00.001). Also, the ephedrine requirement in Group II was lower than in Group I, but the difference was not statistically significant (P\xa0=\xa00.055). The mean arterial pressure for the three groups differed in the 10th, 18th, and 60th minutes. The number of patients with nausea or vomiting was lower in Groups I and II than in Group III (P\xa0<\xa00.001). At 5\xa0min, the Apgar scores were higher than 8 for all neonates. Postoperative scores for the visual analogue scale were similar for all groups.\n\n\nCONCLUSIONS\nIt was concluded that prophylactic IV administration of 3\xa0mg of granisetron or 8\xa0mg of ondansetron before spinal anesthesia results in a significantly lower ephedrine requirement compared to placebo.