Comment: Ondansetron: Timing and dosage

Background and Aim:Nausea and vomiting causes distress to patients and increases surgical complications. Though various antiemetics are available, their effectiveness and fetal safety profile when used in parturient remains debatable. This randomized, double-blind, comparative study was designed with an aim to compare the antiemetic effects of ondansetron and glycopyrrolate during cesarean section.Methods:Sixty-six parturients (American Society of Anesthesiologist physical status I-II) scheduled for elective cesarean section were randomized to receive intravenous ondansetron 4 mg (Group O, n = 32) or glycopyrrolate 0.2 mg (Group G, n = 31) before spinal anesthesia. Outcome measures studied were emesis, episodes of hypotension and bradycardia and pain, till 10 h postoperative. Statistical software used was Epi Info 7 and Microsoft Excel.Results:There was no significant difference in nausea and vomiting at all the study intervals between the two groups statistically. There was no difference in episodes of hypotension, but episodes of bradycardia were significantly less in glycopyrrolate group (26%) than in ondansetron group (56%) (P = 0.027). There was no difference in additional analgesic requirements. However, the incidence of dry mouth was significantly greater in glycopyrrolate group (21 [68%]) as compared to ondansetron group (5 [16%]) (P = 0.00).Conclusion:Effect of glycopyrrolate on nausea and vomiting during cesarean section are comparable to ondansetron, but with an increased incidence of dry mouth. Glycopyrrolate has no effect on hypotension or additional analgesic requirements, but the incidence of bradycardia is significantly less.

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“…[ 7 8 ] On the other hand, ondansetron causes QT prolongation, besides having unknown fetal safety and associated cost issues. [ 3 5 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 ] Ondansetron, a routinely used antiemetic during cesarean section, has no substantial proof of not crossing the placenta or not being excreted in breast milk. [ 3 4 5 ] However, due to their good efficacy, they are routinely used in practice.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of effects of glycopyrrolate and ondansetron on nausea and vomiting in cesarean section under spinal anesthesia

Jain

Sharma

2015

Anesth Essays Res

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“…In our study we used ondansetron in a dose of 4mg as compared to 8mg used in various other studies for prevention of hypotension. 4mg is the recommended dose of ondansetron used for the prophylaxis of postoperative nausea and vomiting 21 . In our set up we follow the same recommendation for PONV prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of effect of prophylactic administration of ondansetron and placebo on prevention of post induction hypotension in elderly patients undergoing surgery in general anesthesia

Bangash

Akhter

Zafar

et al. 2023

J Fatima Jinnah Med Univ

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Background: Post-induction hypotension is a frequently encountered complication seen particularly in elderly population. Hypotension, by impairing vital organ perfusion, increases the morbidity and mortality of the patients. prophylactic use of ondansetron in preventing hypotension after induction of general anaesthesia in elderly patients , hence getting the benefit of preventing both hypotension and postoperative nausea and vomiting by the use of a single drug. Subjects and method: This randomized controlled clinical trial was carried out in the operation theaters of general surgery, Mayo Hospital, Lahore, from 09-09-2017 to 09-09-2018. A total of 80 patients who were to undergo general anaesthesia for elective general surgical procedures were recruited for this study. After taking informed consent, the patients were randomly divided into two groups. Patients in group A received ondansetron and those in group B received placebo prior to the induction of anaesthesia. Efficacy was labeled in terms of absence of hypotension i.e. a drop in mean arterial pressure of no more than 25% of baseline at 1, 3, 5, 9 and 11 minutes after induction of anaesthesia. The data was recorded on a predesigned proforma. Statistical analysis was done using SPSS version 21. Results: Both groups were comparable in terms of age, gender, ASA status, BMI and weight. Efficacy was seen in 19 (47.50%) cases managed by ondansetron vs. 10 (25%) in placebo group (p = 0.03). There was significant difference of efficacy in patients with age between 60 to 70 years where 63.63% patients in the Group A effectively maintained their blood pressure (p=0.02). Patients having age 70 years or above did not show statistically significant difference. History of hypertension made no impact on the efficacy of ondansetron for maintaining blood pressure after induction (p=0.53) Keywords: Ondansetron, Efficacy, Hypotension

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“…[12] We agree that the routine practice is to give antiemetics during surgery. However as discussed by us in the article, this would have confounded the effects of the antiemetic drugs on QTc interval.…”

mentioning

confidence: 99%

Response: Comparative electrocardiographic effects of intravenous ondansetron and granisetron in patients undergoing surgery for carcinoma breast: A prospective single blind randomised trial

Ganjare

Kulkarmi

2013

Indian J Anaesth

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Comment: Ondansetron: Timing and dosage

Cited by 3 publications

References 6 publications

A comparative study of effects of glycopyrrolate and ondansetron on nausea and vomiting in cesarean section under spinal anesthesia

A comparative study of effects of glycopyrrolate and ondansetron on nausea and vomiting in cesarean section under spinal anesthesia

Comparison of effect of prophylactic administration of ondansetron and placebo on prevention of post induction hypotension in elderly patients undergoing surgery in general anesthesia

Response: Comparative electrocardiographic effects of intravenous ondansetron and granisetron in patients undergoing surgery for carcinoma breast: A prospective single blind randomised trial

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