Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul 3;8(2):48-53.
doi: 10.4103/2045-9912.235125. eCollection 2018 Apr-Jun.

Ondansetron 8 mg and 4 mg with normal saline against post-operative headache and nausea/vomiting after spinal anesthesia: a randomized double-blind trial

Shirin Pazoki  1 , Hesameddin Modir  1 , Alireza Kamali  1 , Ashraf Zamani  2 , Marzieh Shahidani  1
Affiliations

Ondansetron 8 mg and 4 mg with normal saline against post-operative headache and nausea/vomiting after spinal anesthesia: a randomized double-blind trial

Shirin Pazoki et al. Med Gas Res. .

Abstract

The study aims to evaluate the efficacy of ondansetron in preventing post-spinal headache, considering the high prevalence of the headache in pregnant women and the common use of the adjuvants for prophylaxis against post-operative nausea and vomiting (PONV). This double-blind clinical trial included the 195 patients who were referred to Taleghani Hospital (in Arak, Iran) for cesarean section (C/S) under spinal anesthesia, and then the subjects were assigned to three equally sized groups using block randomization. Participants in the first, second, and control groups received 8 mg, 4 mg of ondansetron, and normal saline, respectively, 5 minutes before surgery. A final volume of 5 cc was prepared by adding normal saline. Participants were examined for headache one week after surgery, and then data analysis was performed using SPSS 20. The incidence of post-spinal headache was significantly higher in the placebo group than in the ondansetron 8-mg and 4-mg groups at 24 hours after surgery (P < 0.010). But, no significant difference was observed between two ondansetron groups (P ≤ 0.05). The overall incidence of the headache was generally lower in ondansetron 8-mg (26.66% vs. 33.68.05%) and 31.66% in ondansetron 4-mg (P < 0.001). Moreover, the PONV incidence was significantly higher in the placebo group than in the other two groups at 24 hours (P < 0.001). The hemodynamic variables were same in three groups. The ondansetron 8-mg dose can be effective to prevent headache after spinal anesthesia for C/S. Moreover, the ondansetron 8-mg and ondansetron 4-mg have same effect in control of PONV after spinal anesthesia for C/S.

Keywords: cesarean; ondansetron; post spinal headache; post-operative nausea; vomiting.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest There is no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the trial.
Figure 2
Figure 2
Comparison of mean arterial pressure (MAP) in the 8 mg and 4 mg ondansetron and placebo groups. Note: Data are expressed as the mean, and were analyzed by analysis of variance followed by Tukey post hoc test.
Figure 3
Figure 3
Comparison of mean heart rate (HR) in the 8 mg and 4 mg ondansetron and placebo groups. Note: Data are expressed as the mean, and were analyzed by analysis of variance followed by Tukey post hoc test.
See this image and copyright information in PMC

References

    1. Chooi C, Cox JJ, Lumb RS, et al. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev. 2017;8:CD002251. - PMC - PubMed
    1. Yousefshahi F, Dahmardeh AR, Khajavi M, Najafi A, Khashayar P, Barkhordari K. Effect of dexamethasone on the frequency of postdural puncture headache after spinal anesthesia for cesarean section: a double-blind randomized clinical trial. Acta Neurol Belg. 2012;112:345–350. - PubMed
    1. Mehrabi S, Karimzadeh Shirazi K. Results and complications of spinal anesthesia in percutaneous nephrolithotomy. Urol J. 2010;7:22–25. - PubMed
    1. Jabbari A, Alijanpour E, Mir M, Bani Hashem N, Rabiea SM, Rupani MA. Post spinal puncture headache, an old problem and new concepts: review of articles about predisposing factors. Caspian J Intern Med. 2013;4:595–602. - PMC - PubMed
    1. Sachs A, Smiley R. Post-dural puncture headache: the worst common complication in obstetric anesthesia. Semin Perinatol. 2014;38:386–394. - PubMed