在择期剖宫产患者中，于脊髓麻醉前20分钟给予昂丹司琼对血流动力学状态的影响：两种不同剂量的比较。

The effect of ondansetron administration 20 minutes prior to spinal anaesthesia on haemodynamic status in patients undergoing elective caesarean section: A comparison between two different doses.

作者信息

Samarah Walid K, Alghanem Subhi M, Bsisu Isam K, Rahman Zaina Abdel, Guzu Hasan A, Abufares Basil N

机构信息

Department of Anaesthesia, School of Medicine, The University of Jordan, Amman, Jordan.

出版信息

Indian J Anaesth. 2020 Nov;64(11):954-959. doi: 10.4103/ija.IJA_974_19. Epub 2020 Nov 1.

DOI:10.4103/ija.IJA_974_19

PMID:33487680

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7815002/

Abstract

BACKGROUND AND AIMS

Spinal anaesthesia is currently the most common method used for managing patients undergoing elective caesarean sections. Recent meta-analyses have been supporting the use of 5-HT3 antagonists, like ondansetron, to attenuate hypotension induced by spinal block. Various doses of ondansetron were given intravenously five minutes before spinal block. However, a consensus on definitive dose and timing for maximal benefit is yet to be agreed upon.

METHODS

Our prospective randomised clinical trial investigated a new approach by administrating intravenous ondansetron 20 minutes before spinal anaesthesia. This work investigated ondansetron effect on both haemodynamic changes and vasopressors use by dividing patients into three groups. The first group O4 (n = 51) received 4 mg ondansetron, the second group O6 (n = 51) received 6 mg ondansetron, and the control group C (n = 50) received normal saline. We recorded systolic blood pressure (SBP), diastolic blood pressure (DBP) and the mean blood pressure (MBP) at different time intervals.

RESULTS

There was no significant difference in blood pressure measurements among the study groups ( > 0.05). The consumption of ephedrine in the control group is higher than both of the ondansetron groups ( > 0.001), with a mean dose of 27.2 ± 20.5 mg of ephedrine for group C, compared to 17.8 ± 14.9 and 14.7 ± 11.3 in O4 and O6 groups, respectively. Episodes of hypotension and number of patients with hypotension were not significantly different among the studied groups ( = 0.07; = 0.96, respectively).

CONCLUSIONS

Prophylactic 4 and 6 mg ondansetron given 20 minutes before spinal anaesthesia in caesarean section does not reduce the incidence of hypotension.

摘要

背景与目的

脊髓麻醉是目前用于择期剖宫产患者管理的最常用方法。最近的荟萃分析支持使用5 - 羟色胺3（5-HT3）拮抗剂，如昂丹司琼，来减轻脊髓阻滞引起的低血压。在脊髓阻滞前五分钟静脉注射不同剂量的昂丹司琼。然而，关于最大获益的确定剂量和给药时间尚未达成共识。

方法

我们的前瞻性随机临床试验研究了一种新方法，即在脊髓麻醉前20分钟静脉注射昂丹司琼。这项研究通过将患者分为三组来研究昂丹司琼对血流动力学变化和血管升压药使用情况的影响。第一组O4（n = 51）接受4毫克昂丹司琼，第二组O6（n = 51）接受6毫克昂丹司琼,对照组C（n = 50）接受生理盐水。我们记录了不同时间间隔下的收缩压（SBP）、舒张压（DBP）和平均血压（MBP）。

结果

研究组间血压测量值无显著差异（P>0.05）。对照组麻黄碱的消耗量高于两个昂丹司琼组（P>0.001），C组麻黄碱平均剂量为27.2±20.5毫克，而O4组和O6组分别为17.8±14.9毫克和14.7±11.3毫克。研究组间低血压发作次数和低血压患者人数无显著差异（分别为P = 0.07；P = 0.96）。