A Prospective Observational Study of Intravenous Ondansetron and Palonosetron in Attenuating Hypotensive Response Following Spinal Anesthesia in Patients Undergoing Elective Cesarean Section

Abstract

Objective: To compare the efficacy of prophylactic administration of intravenous ondansetron and palonosetron in attenuating hypotensive response following spinal anesthesia in patients undergoing elective cesarean section. Methods: This was a comparative study in which 84 patients aged 18–35 years of American Society of Anesthesiologists physical status II, scheduled for elective cesarean section under spinal anesthesia (SA) were included based on predefined inclusion and exclusion criteria. 84 patients undergoing elective cesarean sections were divided into two groups to receive either ondansetron or palonosetron before SA. Vital signs were monitored, with interventions for hypotension or bradycardia. Data on vital signs, vasopressor use, neonatal Apgar scores, and post-operative symptoms were collected and analyzed. For statistical purposes, a P value less than 0.05 was taken as statistically significant. Results: The mean ages and body mass indexes (BMIs) of the groups were similar, with no significant statistical difference (p=0.674 and p=0.3583, respectively). Heart rates, systolic and diastolic blood pressures showed minor differences, but only a few instances were statistically significant. Mean arterial pressures differed significantly at multiple intervals, but no clinical hypotension was observed. SPO2 levels remained stable and comparable in both groups. Average phenylephrine usage was also similar, with no significant difference. The incidence of hypotension, sedation scores, and incidence of bradycardia were comparable. Neonatal outcomes, measured by APGAR scores, showed no significant difference, indicating similar newborn health status in both groups. Conclusion: Prophylactic ondansetron, as well as palonosetron, were equally effective in reducing the incidence and severity of hypotension in healthy parturients following spinal anesthesia with hyperbaric bupivacaine for elective LSCS.