Hypotension and bradycardia are common complications following spinal anesthesia, particularly in elderly patients with increased cardiovascular vulnerability. Ondansetron, a 5HT3 receptor antagonist, has been suggested to attenuate these effects by inhibiting the Bezold Jarisch reflex, a key mechanism underlying spinal anesthesia induced hypotension. Ondansetron
Conditions
Interventions
Ondansetron 8mg IV before spinal anesthesia,Normal saline IV before spinal anesthesia
Experimental Drug,Placebo Comparator Drug
Sponsors
None listed
Eligibility
Sex/Gender
All
Age
65 Years to 120 Years
Inclusion criteria
Inclusion criteria: 1. Age 65 years old or more 2. ASA class 2-3 3. Scheduled for elective urological surgery under spinal anesthesia
Exclusion criteria
Exclusion criteria: 1. Known allergy to ondansetron 2. Baseline HR < 50 bpm or SBP < 100 mmHg 3. cardiac arrhythmias or conduction block 4. prolonged QT interval on EKG 5. Use of serotonergic medications 6. Congestive heart failure 7. Left Ventricular Ejection Fraction < 40% 8. chronic kidney disease stage 3 or 4 with volume overload 9. chronic kidney disease stage 5 10. Refusal to participate
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| hypotension within 30 minutes following spinal anesthesia non invasive blood pressure monitoring | — |
Secondary
| Measure | Time frame |
|---|---|
| Total vasopressor requirement within 30 minutes after spinal anesthesia Total dose of vasopressor administered for treatment of hypotension | — |
Countries
Thailand
Contacts
Public ContactAmporn Thongphut
Hatyai hospital
Outcome results
None listed