The effect of intravenous ondansetron on maternal spinal-induced hypotension in preeclamptic patients undergoing caesarean delivery: A randomised, controlled clinical trial.
Fei Xiao, Qiang Xu, Zhong-Sai Yang et al.
✦ AI-curated · Sources linked
In 30 seconds
This prospective, double-blinded randomised controlled trial at a single university hospital evaluated intravenous ondansetron for preventing spinal anaesthesia-induced hypotension in 120 preeclamptic patients undergoing caesarean delivery. Patients received 4 mg ondansetron or saline placebo before spinal injection. Hypotension occurred in 30% of the ondansetron group and 55% of the placebo group (mean difference, 25%; 95% CI, 8.4 to 43.9%; P = 0.0009). The authors also concluded that ondansetron reduced phenylephrine requirement.
Key findings
- Hypotension occurred in 30% with ondansetron versus 55% with placebo (mean difference, 25%; 95% CI, 8.4 to 43.9%; P = 0.0009).
- The relative risk of hypotension with intravenous ondansetron was 0.55 (95% CI, 0.34 to 0.84).
- The authors reported reduced phenylephrine requirement with ondansetron; the abstract provides no quantitative estimate.
Why it matters
Spinal anaesthesia-induced hypotension is a relevant concern during caesarean delivery, while prophylactic vasopressors may warrant caution in preeclampsia. This trial provides evidence that ondansetron may reduce hypotension in this population and may also reduce phenylephrine use, informing consideration of preventive strategies without establishing broader safety or effectiveness.
What to keep in mind
The trial was conducted at a single university hospital, which may limit generalisability. The abstract does not report quantitative results for phenylephrine use, adverse effects, or neonatal outcomes.