Comparison of haemodynamic response with Ondansetron vs metoclopramide in emergency caesarean section

Minhas Ashish; Kapoor Krishan Lal

Volume : IX, Issue : VI, June - 2020

Comparison of haemodynamic response with Ondansetron vs metoclopramide in emergency caesarean section

Minhas Ashish, Kapoor Krishan Lal

Abstract :

Background: Although, ondansetron, a 5-HT3 receptor antagonist is safer, its efficacy and safety has not been evaluated in patients of this region. Aim: To evaluate hemodynamic changes with ondansetron with metoclopramide as a premedication during spinal anaesthesia in emergency caesarean sections. Methods: This retrospective study included 30 patients ((aged 20-35 years) American Society of Anesthesiologists grades I and II)) scheduled for emergency CS. The subjects were excluded if contra-indications for spinal anesthesia, known allergy to ondansetron, receiving serotonin agonists or antagonists, ischemic heart disease, chronic hypertension or pregnancy-induced hypertension (PIH). The patients were randomly classified into two groups (15 patients in each group): Group O was given 4 mg ondansetron diluted in 5 ml normal saline slowly IV (over 1 min) 5 min before spinal anesthesia. Group M was given 10 mg metoclopramide in 5 ml of normal saline slowly IV (within 1 min) 5 min before spinal anesthesia. Results: In group O mean systolic BP was significantly high at 5 min (P<0.0001), 15 min (P<0.0001), 30 min (P<0.0001), and 45 min (P=0.002) in comparison to group M. Mean diastolic BP was significantly high at 15 min (P<0.0001), 30 min (P<0.0001), and 45 min (P<0.0001) in comparison to group M. At 5 min intraoperative, there was no significant difference in diastolic BP in both groups (P=0.759). Mean heart rate was significantly high at 15 min (P<0.0001), 30 min (P=0.014), and 45 min (P=0.007) in comparison to group M. At 5 min intraoperative, there was no significant difference in diastolic BP in both groups (P=0.753). Conclusion: Premedication with 4 mg IV ondansetron before spinal anesthesia in an emergency cesarean section maintain hemodynamic changes.