Ropivacaine Spinal Anesthesia Is Not Antagonized by Ondansetron Pretreatment

Paraskeva, Anteia; Chatziara, Vassiliki; Siafaka, Ioanna; Zotou, Marianna; Fassoulaki, Argyro

doi:10.1213/ane.0b013e3181b7c4f6

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…Our results agree with those of Paraskeva et al 6 who found that pretreatment with ondansetron the night before surgery and prior to spinal anaesthesia with ropivacaine had no effect on sensory block. Ropivacaine is a similar local anaesthetic to bupivacaine but less potent 9 .…”

Section: Discussionsupporting

confidence: 93%

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Effect of Intravenous Ondansetron on Sensory and Motor Block after Spinal Anaesthesia with Hyperbaric Bupivacaine

Samra

Bala

Chopra

et al. 2011

Anaesth Intensive Care

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Ondansetron is a potent antiemetic and a competitive antagonist at serotonin receptors, which are also involved in modulation of pain. This study was designed to assess the effect of systemic ondansetron on sensory and motor block after subarachnoid anaesthesia with hyperbaric bupivacaine. Sixty patients undergoing transurethral resection of bladder tumours were randomly assigned to one of two groups. Group 1 received 2 ml (4 mg) of ondansetron whereas patients in group 2 received 2 ml of normal saline 15 minutes prior to administration of subarachnoid block with 2.5 ml of hyperbaric bupivacaine 0.5%. Time to attain peak sensory block (P=0.27), time to two segment regression (P=0.19) and time to regression to the S 2 dermatome (P=0.84) did not significantly differ between the two groups. No differences in regression of sensory block were noted at any time. The mean duration of motor block also did not differ (P=0.44), with similar regression of block at all time intervals except at 90 minutes. We concluded that intravenous ondansetron does not affect the intensity or duration of sensory and motor block after spinal anaesthesia with hyperbaric bupivacaine.

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Section: Discussionsupporting

confidence: 93%

“…Pretreatment with ondansetron and granisetron enhances regression of sensory block after intrathecal administration of 5% hyperbaric lignocaine 4 and hyperbaric bupivacaine 5 respectively. In contrast, pretreatment with high dose ondansetron has no effect on the duration of motor and sensory block after subarachnoid anaesthesia with ropivacaine 6 .…”

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confidence: 77%

Effect of Intravenous Ondansetron on Sensory and Motor Block after Spinal Anaesthesia with Hyperbaric Bupivacaine

Samra

Bala

Chopra

et al. 2011

Anaesth Intensive Care

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“…This finding was consistent with the results of our previous study, where no difference was observed in the ondansetron group compared to placebo, regarding block characteristics in male patients presenting for transurethral surgery under spinal anesthesia with ropivacaine. 24 Moreover, no difference was observed in the occurrence of shivering and this finding is consistent with the results of a meta-analysis by Zhou et al, in which, a favorable antiemetic effect of ondansetron in spinal anesthesia for cesarean section, was recorded. 14…”

Section: Discussionsupporting

confidence: 90%

Failure of two different doses of ondansetron to prevent maternal hypotension in spinal anesthesia with ropivacaine 0.75% for cesarean section; a randomized, double blind trial.

Karachanidi¹

2023

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Introduction: Ondansetron, a selective 5-hydroxytryptamine 3 (5-HT3) receptor antagonist, commonly used as an antiemetic has been proven in recent studies to be effective for the prevention of spinalinduced hypotension for elective cesarean section. Methods:One hundred and thirty-eight healthy primigravida parturients scheduled for elective cesarean section were randomly assigned to three groups. Participants in the ONDA4, ONDA8, and CONTROL groups received 4 mg of ondansetron, 8 mg of ondansetron and normal saline respectively, 10 minutes before spinal anesthesia. Spinal anesthesia was performed at L3-L4 interspinous space, with 1.7 ml ropivacaine 0.75% and 15 mcg of fentanyl, via a 27 G pencil point needle. Blood pressure and heart rate were recorded upon arrival at the operating room, after preloading with 500 ml of 6% hydroxyethylstarch, at the time of spinal injection, and at oneminute intervals for 10 minutes thereafter. Blood pressure and heart rate values, total phenylephrine (mcg) or/and ephedrine (mg) doses, the incidence of maternal nausea/vomiting/shivering, umbilical artery pH and Apgar scores at 1 and 5 min were recorded. Time for the sensory block to reach T4 and regress to T7 dermatome, and the time for the motor block to reach Bromage scale 3 and to regress to Bromage scale 1, were also noted.Results: There were no differences between groups in hemodynamic parameters or doses of vasoactive agents used, sensory or motor block characteristics, incidence of nausea/vomiting, umbilical artery pH or Apgar scores of the neonates. Conclusion:Our results failed to demonstrate the significance of ondansetron in preventing maternal hypotension following spinal anesthesia for cesarian section.

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“…Similar results have also been seen with ondansetron administered to patient prior to spinal anesthesia. [81516]…”

Section: Discussionmentioning

confidence: 99%

“…Similar lack of effects on motor blockade has also been seen in other studies using other 5-HT3 receptors antagonists. [789151619]…”

Section: Discussionmentioning

confidence: 99%

Comparison of IV granisetron and IV palonosetron on hemodynamics and sensory and motor block after spinal anesthesia with hyperbaric bupivacaine in patients undergoing abdominal hysterectomy

Choudhary

Mahajan

et al. 2019

J Anaesthesiol Clin Pharmacol

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Background and Aims: The present study evaluated the effects of two 5-HT3 serotonin receptor antagonists; granisetron and palonosetron on hemodynamics, sensory, and motor blockade induced by intrathecal bupivacaine in patients undergoing abdominal hysterectomy. Material and Methods: In total, 126 female patients (ASA I and II physical status) undergoing abdominal hysterectomy under spinal anesthesia with intrathecal bupivacaine were randomly divided into three groups out of which 40 patients in each group were evaluated for final outcome. Group G received intravenous 1 mg granisetron, group P received intravenous palonosetron 0.075 mg, and group C received intravenous normal saline. Study drug was given 5 min before the spinal anesthesia. Systolic, diastolic and mean arterial blood pressure, heart rate, sensory and motor blockade were assessed. Results: The systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate showed no significant differences among the three groups. Time to reach peak sensory block and modified Bromage 3 motor block, time to two segmental regression of sensory block, and motor regression to modified Bromage score of 0 were not statistically different among the three groups. Although statistically significant early regression of sensory block to segment S1 was seen in group G as compared to group P and group C, it was of no clinical significance. The incidence of nausea and vomiting was significantly lower in group G and P. Conclusion: Intravenous administration of granisetron and palonosetron before intrathecal bupivacaine does not attenuate the hemodynamic changes in patients undergoing abdominal hysterectomy. Further, both 5-HT3 receptors antagonists do not have clinically significant effects on the spinal blockade produced by hyperbaric bupivacaine.

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Ropivacaine Spinal Anesthesia Is Not Antagonized by Ondansetron Pretreatment

Abstract: Ondansetron had no effect on the subarachnoid sensory or motor block produced by ropivacaine.

Cited by 7 publications

References 15 publications

Effect of Intravenous Ondansetron on Sensory and Motor Block after Spinal Anaesthesia with Hyperbaric Bupivacaine

Effect of Intravenous Ondansetron on Sensory and Motor Block after Spinal Anaesthesia with Hyperbaric Bupivacaine

Failure of two different doses of ondansetron to prevent maternal hypotension in spinal anesthesia with ropivacaine 0.75% for cesarean section; a randomized, double blind trial.

Comparison of IV granisetron and IV palonosetron on hemodynamics and sensory and motor block after spinal anesthesia with hyperbaric bupivacaine in patients undergoing abdominal hysterectomy

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