Prophylactic ondansetron for prevention of maternal hypotension following spinal anesthesia in women undergoing cesarean section: a systematic review protocol

Friedly, Christopher; Simmons, Sarah

doi:10.11124/jbisrir-2015-2373

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…The wide difference in these results can be attributed to the lack of a unified definition of hypotension in cesarean section. Some authors defined hypotension as a systolic arterial pressure <100mmHg 13,14 , change ≥ 20% 13,19 or ≥25% 10 from baseline; or change of MAP from baseline ≥25%4 or ≥20% 20 , or diastolic blood pressure < 60 mmHg 21 . Other source of discrepancy that we were able to assess was the presence of co-loading of fluids during cesarean section to treat a decrease in preload, or the time of fasting.…”

Section: Secondary Outcomesmentioning

confidence: 99%

Effect of ondansetron in maternal hypotension during cesarean delivery: an observational study

Szmulewicz,

Saco,

Montanaro

et al. 2023

Acta Anaest Belg

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Background: Spinal anesthesia is the most common anesthetic technique for cesarean delivery. Thus, hypotension is associated with a reduction in uteroplacental flow which may induce fetal morbidity. Activation of the Bezold Jarisch reflex (mediated by 5HT3 receptors) can worsen hypotension and decrease cardiac output. We studied the effect of ondansetron administration before spinal anesthesia on the trajectory of blood pressure during cesarean delivery. Methods: We conducted a retrospective chart review of all cesarean deliveries that occurred between April 1st 2020 and April 1st 2021 and included 85 pregnant women (43 with ondansetron and 42 in the control group). Data were obtained from the electronic medical record database of the British Hospital of Buenos Aires. Socio- demographic, obstetric, anesthetic and perioperative characteristics of patients were assessed. Results: There were no significant differences in the trajectories of the change from baseline of mean arterial blood pressure between ondansetron and control group (0.14% (95% CI: 0.06 to 0.21) per minute). This also applied to heart rate (-0.10% per minute (95% CI: -0.19 to 0.01). The need of any infusion (phenylephrine or atropine) comparing ondansetron to the reference group was 1.12 (95% CI: 0.68, 1.85). There were eight events of shivering (16.3%) in the ondansetron exposed group and four events of shivering (8.5%) in the reference group. APGAR values showed no clinical difference between groups. Conclusions: In this single-center cohort study, we did not observe an effect of routine administration of ondansetron before spinal anesthesia in cesarean section on improving arterial blood pressure or heart rate throughout the procedure.

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Section: Secondary Outcomesmentioning

confidence: 99%

Effect of ondansetron in maternal hypotension during cesarean delivery: an observational study

Szmulewicz,

Saco,

Montanaro

et al. 2023

Acta Anaest Belg

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Eficacia del ondansetron en prevención de hipotensión materna posterior a anestesia raquídea

Andrade¹

2020

Gac Med Bol

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La hipotensión materna es una complicación común de la anestesia raquídea durante la cesárea. El bloqueo de receptores de serotonina 5-HT podría reducir la incidencia de hipotensión y el uso de vasopresores. Objetivo: eficacia del ondansetron como prevención de hipotensión materna posterior a anestesia raquídea. Métodos: un total de 72 pacientes de forma aleatorizada, ensayo clínico y simple ciego. Se administró ondansetron 5 minutos antes del bloqueo anestésico. Grupo O4 (4 mg), grupo O8 (8 mg) y grupo P (placebo) en jeringa de 10 ml, se midió frecuencia cardiaca, presión arterial media, nivel de dermatoma alcanzado, las puntuaciones de Apgar y complicaciones maternas. Resultados: existe diferencia significativa entre los grupos en cuanto a la incidencia de hipotensión y se observó que el requerimiento de vasopresor fue menor en el grupo O8 (p= 0,000), los eventos adversos maternos (p= 0, 087), fueron menores cuando se aplica ondansetron. Las puntuaciones del APGAR fueron similares en los grupos (p= 0,373). Conclusiones: se determina; que el uso de ondansetron atenúa la incidencia de hipotensión aunque no está claro la dosis exacta en las pacientes obstetras, además queda claro es que también disminuye el requerimiento de vasopresor, los efectos adversos como ser prurito, náuseas y vómitos. Limitaciones cantidad de pacientes de estudio y análisis gasométrico por falta de insumo en el hospital.

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Prophylactic ondansetron for prevention of maternal hypotension following spinal anesthesia in women undergoing cesarean section: a systematic review protocol

Cited by 2 publications

References 27 publications

Effect of ondansetron in maternal hypotension during cesarean delivery: an observational study

Effect of ondansetron in maternal hypotension during cesarean delivery: an observational study

Eficacia del ondansetron en prevención de hipotensión materna posterior a anestesia raquídea

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