Ondansetron versus ephedrine in prevention of hypertension after spinal anesthesia in elective cesarean section: a randomized clinical trial

Document Type : Original Article


1 Associate Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Resident, Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

4 B.Sc. in Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.


Introduction: Recently, the effect of serotonin receptor blocking drugs such as Ondansetron to prevent hypotension due to spinal anesthesia, especially in pregnant women has been considered. Therefore, this study was performed with aim to compare intravenous ondansetron versus ephedrine in prevention of hypertension after spinal anesthesia in elective cesarean section.
Methods: This randomized clinical trial was performed with participation of 100 women who were candidate for elective cesarean section in Tabriz Alzahra Hospital in 2018-2019. After random assigning of the subjects to two groups of Ondansetron and Ephedrine, immediately after anesthesia injection, 4 mg of Ondansetron (intervention group) and 10 mg of ephedrine (control group) were injected into each group. Blood pressure status during surgery for each group was recorded in the tool of each subject in the form of data collection. Data were analyzed by SPSS software (version 22) and T-test, Mann-Whitney U and Chi-square tests. P<0.05 was considered statistically significant.
Results: The mean total dose of ephedrine for Ondansetron group was 12.33 ± 2.20 mg and for ephedrine group was 19.41 ± 3.29 mg (p= 0.003).After anesthesia, statistically significant difference was found between the two groups in terms of heart rate (p=0.002), systolic blood pressure (p=0.03), diastolic blood pressure (p=0.04), nausea and vomiting (p=0.009) and restlessness (p=0.019).
Conclusion: Prophylactic administration of Ondansetron in pregnant women with elective cesarean section reduced the need for ephedrine and also decreased the complications.


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