Effects of Intravenous Ondansetron and Granisetron on Haemodynamic Changes during Spinal Anaesthesia in Non-obstetric Population: A Randomised Double-blind Study UC01-UC04
Dr. Aloka Samantaray,
Department of Anaesthesiology and CCM, Sri Venkateswara Institute of Medical Sciences, Tirupati-517507, Andhra Pradesh, India.
Introduction: Two commonly used antiemetics in the perioperative period may attenuate the spinal anaesthesia induced hypotension by attenuating the Bezold-Jarisch Reflex (BJR).
Aim: To evaluate and compare the efficacy of intravenous administration of ondansetron and granisetron five minutes prior to spinal anaesthesia on incidence of spinal anaesthesia induced hypotension and bradycardia.
Materials and Methods: Ninety patients scheduled for elective infraumbilical non-obstetric surgeries under spinal anaesthesia were enrolled for the study, after obtaining written informed consent. Patients were randomised to receive 4 mg ondansetron (group O), 1 mg granisetron (group G) or normal saline (control group) intravenously, five minutes prior to spinal anaesthesia. Changes in haemodynamics were noted after spinal anaesthesia to identify the number of episodes of hypotension and bradycardia necessitating treatment with ephedrine, atropine or both. The obtained data was analysed with one-way ANOVA or Chi-square test with post-hoc comparison to find out pairwise difference. Statistical significance was considered as p<0.05.
Results: The incidence of hypotension was highest in control group (46%) in contrast to 23% in granisetron and ondansetron group, however the difference did not reach the level of statistical significance (p=0.07). The usage of atropine was similar among the groups, whereas consumption of ephedrine was significantly different among the three groups (p=0.037) with granisetron group consuming the least dose of ephedrine to treat spinal anaesthesia induced hypotension.
Conclusion: We conclude that pretreatment with ondansetron, granisetron do not reduce the incidence of spinal anaesthesia induced hypotension and bradycardia.