ONDANSETRON VERSUS GRANISETRON EFFECTS ON HEMODYNAMIC INSTABILITY DURING SPINAL ANESTHESIA FOR CESAREAN SECTION

Alaa El Deen Mahmoud Sayed* and Ahmed Shaaban Mohamed

ABSTRACT

Background: Spinal anesthesia avoids the risks involved in managing the airway of the parturient. Hypotension, shivering, nausea and vomiting are frequent risks in patients undergoing cesarean delivery under spinal anesthesia, Prophylactic intravenous administration of serotonin receptor antagonists such as ondansetron and granisetron has been used to overcome this problems. Objective: This study evaluated the efficacy of intravenous ondansetron and granisetron on hemodynamics, shivering and motor & sensory block in female undergoing elective cesarean section under spinal anesthesia. Patient and Method: Seventy five patients were assigned to three equal groups: group O received 4 mg Ondansetron, group G received 1 mg Granisetron and group S received 10 ml normal saline 5 min before spinal anesthesia. The incidence of hypotension, bradycardia, SaO2 changes, shivering, nausea and vomiting were recorded at baseline monitoring, intraoperative and postoperative. Also propagation and regression of motor and sensory block were assessed. Results: There was significant difference as regard decrease in mean arterial blood pressure and presence of shivering, nausea and vomiting between group S and both groups O and G, also there was significant difference as regard faster time to regression of sensory block between group G and both groups O and S. Conclusion: Prophylactic intravenous administration of 4 mg ondansetron or 1 mg granisetron 5 min before induction of spinal anesthesia in cesarean section can significantly reduces the severity of spinal-induced hypotension, reduce the incidence of nausea, vomiting and shivering. Regression of sensory block was faster with granisetron more than ondansetron and normal saline.

Keywords: Cesarean section, granisetron, ondansetron, spinal anesthesia.