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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2015 Giugno;81(6):598-607
Ondansetron attenuates the decrease in blood pressure due to spinal anesthesia in the elderly: a double blind, placebo-controlled study
Owczuk R. 1, Wenski W. 2, Twardowski P. 1, Dylczyk-Sommer A. 1, Sawicka W. 1, Wujtewicz M. A. 3, Marciniak A. 1, Polak-Krzemińska A. 4, Jasiński T. 1, Wujtewicz M. 1 ✉
1 Department of Anesthesiology and Intensive Therapy, Medical University of Gdańsk, Gdańsk, Poland;
2 Department of Anesthesiology and Intensive Therapy, District Hospital, Elbląg, Poland;
3 Department of Ophtalmology, Medical University of Gdańsk, Gdańsk, Poland;
4 Department of Pediatric Anesthesiology and Intensive Therapy, Copernicus Hospital, Gdańsk, Poland
BACKGROUND: Ondansetron was effectively used to prevent spinal anesthesia-induced hypotension in the general population and women anesthetised for cesarean section. The aim of this study was to test the hypothesis that blocking type 3 serotonin receptors with intravenous ondansetron administration reduces hypotension and bradycardia induced by spinal anesthesia in elderly patients.
METHODS: Fifty-three patients participated in the study with 26 in the ondansetron group (received 8 mg intravenous ondansetron) and 27 in the placebo group (received 0.9% NaCl solution). The heart rate and arterial blood pressure were measured every 5 minutes after spinal anaesthesia, which was performed with 2.5 to 3 mL of 0.5% hyperbaric bupivacaine solution.
RESULTS: Decreases in both the heart rate and mean systolic, as well as diastolic, arterial pressure compared to the baseline values were noted in both groups. The minimum diastolic and mean blood pressure values obtained over a 20-minute observation period were significantly higher in the ondansetron group. There were no significant differences in the systolic blood pressure and heart rate values between the groups.
CONCLUSION: Administration of intravenous ondansetron prior to spinal anesthesia in geriatric patients attenuates the drop in the diastolic and mean arterial pressure without substantially affecting the systolic blood pressure.