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Effects of Ondansetron on Attenuating Spinal Anesthesia-Induced Hypotension and Bradycardia in Obstetric and Nonobstetric Subjects: A Systematic Review and Meta-Analysis.

Hypotension and bradycardia are common adverse effects following spinal anesthesia. Ondansetron has been studied in the attenuation of spinal anesthesia-induced hypotension (SIH) and bradycardia because of its antagonistic effect on the Bezold-Jarisch reflex. The purpose of this systematic review an...

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Published in:AANA Journal Vol. 85; no. 2; pp. 113 - 123
Main Author: Tubog, Tito D.
Format: meta analysis research systematic review tables/charts Journal Article
Published: American Association of Nurse Anesthetists Apr2017
Online Access:View this record in EBSCOhost
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      dt: Apr2017
      vid: 85
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      pid: 11824
      pub: American Association of Nurse Anesthetists
      place: Park Ridge, Illinois
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        atl: Effects of Ondansetron on Attenuating Spinal Anesthesia-Induced Hypotension and Bradycardia in Obstetric and Nonobstetric Subjects: A Systematic Review and Meta-Analysis.
      aug:
        au: Tubog, Tito D.
        affil: Associate professor of psychology at Texas Wesleyan University, Fort Worth, Texas
      sug:
        subj:
          Ondansetron Administration and Dosage
          Anesthesia, Spinal Adverse Effects
          Hypotension Prevention and Control
          Bradycardia Prevention and Control
          Human
          Systematic Review
          Meta Analysis
          Hypotension Chemically Induced
          Bradycardia Chemically Induced
          Relative Risk
          Confidence Intervals
          Medline
          CINAHL Database
          Cochrane Library
      ab: Hypotension and bradycardia are common adverse effects following spinal anesthesia. Ondansetron has been studied in the attenuation of spinal anesthesia-induced hypotension (SIH) and bradycardia because of its antagonistic effect on the Bezold-Jarisch reflex. The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to determine the efficacy of intravenous (IV) ondansetron in reducing the incidence of SIH and bradycardia. Thirteen RCTs were included in this analysis, totaling 1,225 subjects. Hypotension and bradycardia were summarized using a risk ratio (RR) with 95% confidence interval (CI). Heterogeneity was summarized using random-effects model for I² greater than 50%; otherwise, a fixed-effects model was performed. Intravenous ondansetron reduced the incidence of hypotension in both the all-procedure analysis group (RR, 0.64; CI, 0.45-0.90) and cesarean delivery group (RR, 0.63; CI, 0.45-0.88). For bradycardia, IV ondansetron resulted in reduced risk (RR, 0.31; CI, 0.19-0.50). Findings of our meta-analysis suggest that IV ondansetron may mitigate the risks of SIH and bradycardia following spinal anesthesia.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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