Ondansetron Preloading with Crystalloid Infusion Reduces Maternal Hypotension during Cesarean Delivery

Qun Wang; Lang Zhuo; Ming-Kun Shen; Yan-Yun Yu; Jun-Jing Yu; Meng Wang

doi:10.1055/s-0033-1364189

American Journal of Perinatology, Table of Contents

Am J Perinatol 2014; 31(10): 913-922
DOI: 10.1055/s-0033-1364189

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ondansetron Preloading with Crystalloid Infusion Reduces Maternal Hypotension during Cesarean Delivery

Qun Wang

¹Department of Anesthesiology, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi, China

,

Lang Zhuo

²School of Public Health, Xuzhou Medical College, Xuzhou, China

,

Ming-Kun Shen

¹Department of Anesthesiology, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi, China

,

Yan-Yun Yu

¹Department of Anesthesiology, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi, China

,

Jun-Jing Yu

¹Department of Anesthesiology, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi, China

,

Meng Wang

¹Department of Anesthesiology, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi, China

› Author Affiliations

Abstract

Objective The aim of the article was to investigate the effect of ondansetron preloading with crystalloid infusion after spinal anesthesia during cesarean delivery.

Study Design A total of 66 parturient women scheduled for elective caesarean sections were randomly assigned to two groups. Five minutes before spinal anesthesia, Group O patients were injected with 4 mg of ondansetron, while Group S patients were injected with 5 mL physiological saline. Maternal blood pressure and heart rate were measured at 2 minute intervals for 30 minutes. After delivery, umbilical cord blood samples were analyzed.

Results Maternal hypotension and nausea were significantly lower in ondansetron-treated patients versus placebo (p = 0.011 vs. 0.004). Umbilical venous pH was significantly higher in ondansetron-treated patients (p = 0.006), while partial pressure of carbon dioxide (Pco ₂) was significantly lower (p = 0.002). Decreases in maternal systolic and mean arterial blood pressures were significantly lower in ondansetron-treated patients (p = 0.008 vs. 0.025), with less requirement for phenylephrine administration compared with controls (p = 0.029).

Conclusion Ondansetron preloading combined with crystalloid infusion significantly reduced hypotension and nausea, while improving acid–base status, as well as reducing vasoconstrictor use.

Keywords

ondansetron - hypotension - spinal anesthesia - cesarean delivery

Full Text

References

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