The Effects of Intravenous Granisetron on the Sensory and Motor Blockade Produced by Intrathecal Bupivacaine

Mowafi, Hany A.; Arab, Samer A; Ismail, Salah A.; Alghamdi, Abdullah

doi:10.1213/ane.0b013e318165e012

Cited by 20 publications

(22 citation statements)

References 20 publications

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“…Rashad et al [18] compared the hemodynamic effects of granisetron and ondansetron among patients undergoing cesarean deliveries under spinal anesthesia. However, this study demonstrated that granisetron had no effects on patients’ hemodynamic variables, in agreement with the findings of Mowafi et al [25].…”

Section: Discussionsupporting

confidence: 93%

Randomized controlled trial comparing ondansetron and placebo for the reduction of spinal anesthesia-induced hypotension during elective cesarean delivery in Egypt

Khouly

Meligy

2016

International Journal of Gynecology & Obstetrics

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Section: Discussionsupporting

confidence: 93%

Randomized controlled trial comparing ondansetron and placebo for the reduction of spinal anesthesia-induced hypotension during elective cesarean delivery in Egypt

Khouly

Meligy

2016

International Journal of Gynecology & Obstetrics

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“…7,8 There was reversal of antinociceptive effects of intrathecally administered serotonin in rat by selective 5-HT3 receptor anatagonist. 6 Ondansetron blocked nifedipine induced analgesia in rats. 9 After intrathecal injection of 0.5% bupivacaine both cerebrospinal fluid (CSF) and plasma, serotonin were determined radio enzymatically before and after anesthesia no change in plasma serotonin level but 300% increase in CSF serotonin level.…”

Section: Discussionmentioning

confidence: 98%

Effect of ondansetron on sensory level produced by intrathecal bupivacaine

Singh

Kannaujia

et al. 2015

Int J Basic Clin Pharmacol

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INTRODUCTIONBupivacaine provides longer duration of spinal anesthesia than lidocaine. Various drugs like opioids, 1 neostigmine, 2 clonidine, 3 and nitrous oxide 4 have been studied to prolong the effect of sensory block. However, there are few drugs which decrease the duration and quality of spinal anesthesia which makes situation embarrassing for anesthesiologist e.g. nimodipine, 5 granisetron 6 causes decreased sensory level. Hence, any drug which decreases spinal block level ABSTRACT Background: For spinal anesthesia there are drugs which can increase the level and quality of analgesia. Any drug which decreases sensory block level in spinal anesthesia is of great concern as it may need analgesic, sedative, supplement or even conversion to general anesthesia. Ondansetron is one such drug which has been reported to decrease the height of sensory block achieved after subarachnoid administration of bupivacaine. In this prospective observational study, we studied the effect of administration of ondansetron on the level of the sensory block achieved after subarachnoid blockade. Methods: In Group II, 4 mg ondansetron was given and 15 mins before giving spinal anesthesia Group II against control group receiving 2 ml saline intravenous (Group I). 15 mins before giving spinal anesthesia. Both groups received 3.5 ml of bupivacaine heavy was given intrathecally. Sensory and motor block was assessed 5, 15, and 30 mins. We analyzed both highest spinal block level achieved and time to regress to L1 level. Results: We found that in Group II both highest level of sensory block (T6 by median method) duration to regress to L1 level (1.43±0.22 hrs) was lesser as compared to group I and Group III T4 by median method and time to regress from T6 to L1 Group I 2.03±0.06 hrs Group III 1.84±0.27 hrs. Motor block did not differ between groups. Conclusions: We concluded that probably ondansetron was responsible for lower spinal block level and early recovery from spinal anesthesia after intrathecal bupivacaine and should not be given empirically for nausea and vomiting.

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“…Granisetron, in contrast to ondansetron, which acts on mixed receptors, strongly and selectively binds to the 5-HT3 receptors with minimal or no affinity for other 5-HT receptors, or dopaminergic, adrenergic, histaminic, and opioid receptors and hence has faster regression of sensory effect in comparison to ondansetron. 15 The mechanism for 5-HT3-receptor antagonists for prevention of shivering is still unclear but is thought to be related to inhibition of serotonin reuptake on the preoptic anterior hypothalamic region and also serotonin (5-HT) is a critical thermoregulatory neurotransmitter, it decreases core temperature attenuation that triggers shivering. 16 In present study intravenous ondansetron 4mg, given five minutes before spinal anaesthesia effectively attenuated the fall in systolic blood pressure, diastolic blood pressure, and mean arterial pressure after spinal anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

A comparative evaluation of effect of intravenous premedication with ondansetron versus granisetron on hemodynamics and sensory-motor blockade produced by intrathecal hyperbaric 0.5% bupivacaine

Kumar

Inayat²,

Rastogi

et al. 2019

Int J Res Med Sci

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Background: Bezold Jarisch reflex is important cause of hypotension and bradycardia which occur after spinal anaesthesia. This reflex is elicited by stimulation of peripheral serotonin receptors 5- hydroxytryptamine (5- HT3 type). These receptors have antinociceptive effect, which is confirmed by many studies.The two most commonly used 5HT3 antagonist are ondansetron and granisetrone. Very few comparative studies of the two drugs on the effect after spinal anaesthesia are available.Methods: Ninety adulted patients of either sex aged 18-58 years scheduled for elective infraumbilical surgeries were randomly allocated in three groups to receive intravenous ondansetron 4mg, granisetrone 2mg or normal saline in equal volume 5mins before spinal anesthesia. Hemodynamic changes and time to sensory motor onset and regression were evaluated.Results: There was statistically significant difference in fall of systolic diastolic and mean blood pressure among the three groups. Time to two segment regression of sensory block and time to regression to S1 was faster in ondansentron (76.6±17.2mins, 176±22mins) and granisetrone group (69±17.3mins, 165±19.2mins) in comparision to control group(77.4±24.3mins, 178±21mins) which was statistically significant also p value-0.019, 0.0001 respectively.Conclusions: The prophylactic therapy with 4mg i.v. ondansetron, given five minutes before spinal anaesthesia appears to be significantly most effective and safe for attenuating haemodynamic response after spinal anaesthesia without affecting the duration of sensory block in patients undergoing infraumbilical surgeries.

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The Effects of Intravenous Granisetron on the Sensory and Motor Blockade Produced by Intrathecal Bupivacaine

Abstract: We concluded that i.v. granisetron facilitated a faster recovery of sensory block after bupivacaine subarachnoid anesthesia.

Cited by 20 publications

References 20 publications

Randomized controlled trial comparing ondansetron and placebo for the reduction of spinal anesthesia-induced hypotension during elective cesarean delivery in Egypt

Randomized controlled trial comparing ondansetron and placebo for the reduction of spinal anesthesia-induced hypotension during elective cesarean delivery in Egypt

Effect of ondansetron on sensory level produced by intrathecal bupivacaine

A comparative evaluation of effect of intravenous premedication with ondansetron versus granisetron on hemodynamics and sensory-motor blockade produced by intrathecal hyperbaric 0.5% bupivacaine

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