title: Effect of ondansetron on post-dural puncture headache (PDPH) in parturients undergoing cesarean section: a double-blind randomized placebo-controlled study.
abstract: OBJECTIVE
  One of the most exhausting complications of spinal anesthesia, especially in parturients, is post-dural puncture headache (PDPH). This headache is not responsive to the usual pain killers. Ondansetron is a 5-HT3 receptor antagonist which is generally used for the prophylactic management of nausea and vomiting; however, studies have found that ondansetron might decrease the incidence of PDPH. Therefore, we aimed to evalute the effect of ondansetron on decreasing the incidence of PDPH.
  
  
  METHODS
  In this double-blind randomized placebo-controlled clinical trial, 210 parturients who underwent elective cesarean section under spinal anesthesia were randomly allocated to two groups. The intervention group received 0.15 mg/kg ondansetron, while the control group received 5 ml normal saline. Heart rate and mean arterial pressure (MAP) were recorded during surgery. Furthermore, postoperative nausea and vomiting (PONV) and PDPH in the two groups were noted by an anesthetic nurse for 3 days and compared.
  
  
  RESULTS
  The incidence of PDPH in the intervention group was significantly lower than in the control group (P = 0.001). The incidence of PONV was also significantly lower in the intervention group compared to the control group (P < 0.05). However, MAP was significantly higher in the intervention group compared to the control group (P < 0.05). No significant difference was found between the two groups regarding heart rate (P > 0.05).
  
  
  CONCLUSIONS
  Ondansetron (0.15 mg/kg) appeared to reduce the incidence of PDPH, as well as the incidence of hypotension and PONV, in parturients undergoing spinal anesthesia for cesarean section.
authors: Shiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Zainabosadat
authors: Z
authors: Fattahi
authors: Shiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: Seyed Mohammad Reza
authors: SM
authors: Hadavi
authors: Shiraz Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. sahmeddini@sums.ac.ir.
authors: Mohammad Ali
authors: MA
authors: Sahmeddini
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods; D000932:Antiemetics / Q000627:therapeutic use*; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000517:prevention & control; D015994:Incidence; D017294:Ondansetron / Q000627:therapeutic use*; D051299:Post-Dural Puncture Headache / Q000209:etiology* / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D055815:Young Adult
chemical_list: D000932:Antiemetics; D017294:Ondansetron
keywords: Parturient; Post-dural puncture headache; Spinal anesthesia