Intravenous granisetron attenuates hypotension during spinal anesthesia in cesarean delivery: A double-blind, prospective randomized controlled study.
OBJECTIVE
This study was conducted to determine the effectiveness of intravenous (IV) granisetron in the prevention of hypotension and bradycardia during spinal anesthesia in cesarean delivery.


METHODS
A total of 200 parturients scheduled for elective cesarean section were included in this study. They were randomly divided into two groups. Group I was given 1 mg granisetron diluted in 10 ml normal saline slowly IV, 5 min before spinal anesthesia. Group II was given 10 ml of normal saline, 5 min before spinal anesthesia. Mean arterial blood pressure and heart rate (HR) were recorded every 3 min until the end of surgery (for 45 min). The total consumption of vasopressors and atropine were recorded. Apgar scores at 1 and 5 min were also assessed.


RESULTS
Serial mean arterial blood pressure and HR values for 45 min after onset of spinal anesthesia were decreased significantly in group II, P < 0.0001. The incidence of hypotension after spinal anesthesia was 64% in group II and 3% in group I (P < 0.0001). The total doses of ephedrine (4.07 ± 3.87 mg vs 10.7 ± 8.9 mg, P < 0.0001), phenylephrine (0.0 microg vs 23.2 ± 55.1 microg, P < 0.0001), and atropine (0.0 mg vs 0.35 ± 0.49 mg P < 0.0001) consumed in both the groups respectively, were significantly less in group I versus group II.


CONCLUSIONS
Premedication with 1 mg IV granisetron before spinal anesthesia in an elective cesarean section significantly reduces hypotension, bradycardia and vasopressors usage.
Department of Anesthesia and Surgical Intensive Care, Tanta University Hospital, Tanta University, Tanta, Egypt.
Ahmed A
AA
Eldaba
Department of Anesthesia and Surgical Intensive Care, Tanta University Hospital, Tanta University, Tanta, Egypt.
Yasser M
YM
Amr
Cesarean; granisetron; hypotension; spinal anesthesia