Evaluation of the Effects of Ondansetron Administration in the ERAS Protocol on Regional Anesthesia in Cesarean Surgeries: A Prospective Randomized Study

Abstract

Objective:The enhanced recovery after surgery protocol has been applied more frequently in cesarean surgeries, and regional anesthesia is the first choice because of its postoperative advantages. Hypotension and bradycardia are common side effects of spinal anesthesia. Bezold Jarisch reflex, which occurs by the stimulation of 5-HT3 receptors, is thought to be effective. This study was planned as a prospective randomized study to investigate the effect of ondansetron, a 5-HT3 receptor antagonist, on hemodynamics in pregnant women undergoing cesarean section under spinal anesthesia.Method:Seventy-eight pregnant women scheduled for elective cesarean section with spinal anesthesia were included in the study. Patients were randomly divided into two groups; group 1 (n=38) received ondansetron 4 mg intravenously before spinal anesthesia, and group 2 (n=40) did not receive ondansetron. Blood pressure, peak heart rate, and vasopressor requirements were evaluated in both groups.Results:The reductions in the mean arterial pressure were significantly lower in group 2 than in group 1 at 2 and 4 minutes (p<0.05). Patients in group 1 had a lower need for vasopressors (p=0.001) and a significantly lower incidence of nausea and vomiting (p=0.01).Conclusion:When ondansetron was used before spinal anesthesia in pregnant women undergoing elective cesarean section, hemodynamics were more stable, vasopressor use was reduced, and nausea and vomiting were reported to be less.

Keywords

• eras
• nausea
• ondansetron
• spinal anesthesia
• vomiting