The Effectiveness of Ondansetron in Preventing Hypotension and Bradicardia in Spinal Anestesia
Nasution, Akhyar Hamonangan
Tanjung, Qadri Fauzi
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Background: Spinal anesthesia was typically used for elective surgery and was associated with the incidence of hypotension and bradycardia due to sympathetic block. Bezold-Jarisch reflex (BJR) is a reflex that contributes to cause hypotension and bradycardia mediated by serotonin receptors (5-HT3). Ondansetron, a 5-HT3 receptor antagonist, is assumed to inhibit the effect of serotonin and BJR. Aim: To assess the effectiveness of ondansetron in preventing hypotension and bradycardia after spinal anesthesia. Methods: This study was an experimental study with a "posttest with control group" design conducted at Haji Adam Malik General Hospital and USU Hospital in February 2020 to June 2020. Seventy study subjects who underwent lower abdominal, gynecology, lower extremities under spinal anesthesia were selected by consecutive sampling and were divided into 2 groups. Group 1 received 4 mg ondansetron, while group 2 received 2 cc normal saline, both interventions were given 30 minutes before spinal anesthesia Results: Baseline and minimum mean arterial pressure were higher in the ondansetron group at 97.07 ± 5.09 mmHg and 85.20 ± 6.48 mmHg compared to the control group (p-value <0.05). Hypotension was more common in the control group (51.43%) than in ondansetron group (20%) (p-value <0.05). The mean baseline and minimum heart rate were higher in the ondansetron group at 81,09 ± 9,62 bpm and 79.7 ± 8.75 bpm compared to the control group (p<0.05). The incidence of bradycardia was more common in the control group (17.1%) compared to the ondansetron group (2.9%) (p-value <0.05). Conclusion: Ondansetron 4 mg, given intravenously, is effective in lowering the incidence of hypotension and bradycardia under spinal anesthesia.