Published Paper Details:

For conducting caesarean sections sub arachnoid blocks are shown to be an easy, safe, and most commonly followed anesthetics technique. Nonetheless its connotation with some side effects like perioperative hypotension, bradycardia nausea and vomiting can't be ignored. The majority of these side effects are induced by sympathetic blockade, hypovolemia and Bezold-Jarisch reflex through intra-cardiac serotonin (5HT3) receptors and vague nerve. Various studies have already established the use of 5HT3 antagonists like Ondansetron in preventing the serotonin induced BJR and thus peri-operative hypotension. In the present study, it was imaginedby blocking type 3 serotonin receptors by intravenous (i.v.) ondansetrondecreases the incidence of hypotension brought by spinalanesthesia After procurement approval of recognized ethical group, and printed informed consent we conducted a study in 100 pregnant patients aged between 18-45 years with ASA 1 and 2status planned for an elective caesarean section at term. This is a potential, randomized, measured, double blinded study. Group I (n=50) received 4milligram ondansetron in 10 ml saline intravenously 5 mins before spinal puncture. Group II (n=50) received10 ml saline in the same way and at the same timing. Patients in both the group I and II received 1000 ml of Ringers lactate solutionover30 minutes in the pre-operative room prior to induction of spinal anesthesia which was induced using2.2 ml of 0.5% Bupivacaine heavy injected in intrathecalspaceinboththegroupsbysameanesthesiologist.Standard ASA monitoring including, ECG, Pulse oximetry and NIBP was recorded in both the groups. Measurements of BP and heart rate (HR) was taken every 5 minutes for 60 minutes. Hypotension was defined as a reduction in mean arterial pressure (MAP) of more than 20%, and 3 mg of me phentermine was administered intravenously. Bradycardia was defined as a reduction in heart rate of more than 20%, and atropine 0.6 mg iv was administered intravenously. Results Both groups are comparable in demographic. Statistically significant difference was noted in the Systolic Blood Pressures in both the groups at 0, 10, 20, 30, 40, 50 mins and 1-hour post sub arachnoid block. Requirement of vasopressor was significantly low in Group I 9 patients (18%) with a p=0.005 as compared to group II 32 (64%)patients Conclusion:It was safely concluded that administering intravenous ondansetron prior to spinal puncture significantly depress the incidence of hypotension and requirement of vasopressors.