Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trial
Background and Aims: Various pharmacological and non-pharmacological strategies have been employed to minimise hypotension during obstetric spinal anaesthesia. We compared a prophylactic combination of glycopyrrolate, ondansetron, and ephedrine in terms of total vasopressor consumption, with standar...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2021;volume=65;issue=12;spage=862;epage=867;aulast=Vadhanan |
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| author | Prasanna Vadhanan Cheran Kalyanasundaram Subbulakshmi Sundaram Iniya Rajendran Preethipriyadarshini Rajasekar |
| author_facet | Prasanna Vadhanan Cheran Kalyanasundaram Subbulakshmi Sundaram Iniya Rajendran Preethipriyadarshini Rajasekar |
| author_sort | Prasanna Vadhanan |
| collection | DOAJ |
| description | Background and Aims: Various pharmacological and non-pharmacological strategies have been employed to minimise hypotension during obstetric spinal anaesthesia. We compared a prophylactic combination of glycopyrrolate, ondansetron, and ephedrine in terms of total vasopressor consumption, with standard treatment in this randomised controlled trial. Methods: One hundred patients undergoing elective caeserean sections were randomly divided into two groups of 50 each, the study group received prophylactic ondansetron and glycopyrrolate boluses followed by an infusion of ephedrine, while the control group received ephedrine boluses as required. The total ephedrine consumption (primary objective), incidence and degree of hypotension, heart rate variations, and neonatal APGAR scores (secondary objectives) were analysed. Results: The median ephedrine requirement was lesser in the study group compared to the control group [13.2 mg (10--15.75) vs. 27.7 mg (12--24)], with a P value of 0.02. Fewer participants experienced hypotension in the study group before baby delivery compared to the control group (12 vs. 36, P = 0.004). Heart rate was higher in the study group. No significant differences were observed in neonatal APGAR scores and incidence of adverse events. Conclusion: A combination of glycopyrrolate, ondansetron, and ephedrine might offer better haemodynamic stability and reduce vasopressor consumption in obstetric patients undergoing spinal anaesthesia as opposed to standard treatment. |
| first_indexed | 2024-12-24T01:32:21Z |
| format | Article |
| id | doaj.art-b2ce057f12ce4fa0bff03577614e69b2 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-12-24T01:32:21Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-b2ce057f12ce4fa0bff03577614e69b22022-12-21T17:22:19ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172021-01-01651286286710.4103/ija.ija_870_21Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trialPrasanna VadhananCheran KalyanasundaramSubbulakshmi SundaramIniya RajendranPreethipriyadarshini RajasekarBackground and Aims: Various pharmacological and non-pharmacological strategies have been employed to minimise hypotension during obstetric spinal anaesthesia. We compared a prophylactic combination of glycopyrrolate, ondansetron, and ephedrine in terms of total vasopressor consumption, with standard treatment in this randomised controlled trial. Methods: One hundred patients undergoing elective caeserean sections were randomly divided into two groups of 50 each, the study group received prophylactic ondansetron and glycopyrrolate boluses followed by an infusion of ephedrine, while the control group received ephedrine boluses as required. The total ephedrine consumption (primary objective), incidence and degree of hypotension, heart rate variations, and neonatal APGAR scores (secondary objectives) were analysed. Results: The median ephedrine requirement was lesser in the study group compared to the control group [13.2 mg (10--15.75) vs. 27.7 mg (12--24)], with a P value of 0.02. Fewer participants experienced hypotension in the study group before baby delivery compared to the control group (12 vs. 36, P = 0.004). Heart rate was higher in the study group. No significant differences were observed in neonatal APGAR scores and incidence of adverse events. Conclusion: A combination of glycopyrrolate, ondansetron, and ephedrine might offer better haemodynamic stability and reduce vasopressor consumption in obstetric patients undergoing spinal anaesthesia as opposed to standard treatment.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2021;volume=65;issue=12;spage=862;epage=867;aulast=Vadhanananaesthesia spinalcaeserean sectionephedrineglycopyrrolatehypotensionondansetron |
| spellingShingle | Prasanna Vadhanan Cheran Kalyanasundaram Subbulakshmi Sundaram Iniya Rajendran Preethipriyadarshini Rajasekar Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trial Indian Journal of Anaesthesia anaesthesia spinal caeserean section ephedrine glycopyrrolate hypotension ondansetron |
| title | Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trial |
| title_full | Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trial |
| title_fullStr | Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trial |
| title_full_unstemmed | Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trial |
| title_short | Effect of prophylactic combination of glycopyrrolate, ondansetron, and ephedrine upon hypotension during obstetric spinal anaesthesia–A randomised controlled trial |
| title_sort | effect of prophylactic combination of glycopyrrolate ondansetron and ephedrine upon hypotension during obstetric spinal anaesthesia a randomised controlled trial |
| topic | anaesthesia spinal caeserean section ephedrine glycopyrrolate hypotension ondansetron |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2021;volume=65;issue=12;spage=862;epage=867;aulast=Vadhanan |
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