scholarly journals Effect of granisetron in attenuation of hypotension following spinal anaesthesia in parturients undergoing elective caesarean section - a double blind randomized controlled trial

2016 ◽  
Vol 3 (1) ◽  
pp. 13-17
Author(s):  
Suraj Lamichhane ◽  
Siddhartha Koirala ◽  
Satyendra Narayan Singh
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Arterial Pressure ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Saline Control ◽  
Induced Hypotension ◽  
Pre Treatment ◽  
Type 3 ◽  
Change In Mean

Background: Spinal anaesthesia has side effects like hypotension and bradycardia, which may be induced by sympathetic blockade and Bezold-Jarisch reflex (mediated by peripheral serotonin receptor, 5-HT3 type). The objective of the study was to evaluate the effects of type 3 serotonin receptors blockade by intravenous granisetron  pre-treatment  in  spinal  induced hypotension in parturient undergoing elective caesarean section.Methods: Fifty six parturient with American Society of Anaesthesiologists Physical Status I and II undergoing elective caesarean section were assigned randomly to receive either Normal Saline (control) or Granisetron 1mg intravenously five minutes before spinal anaesthesia. Spinal anaesthesia was performed with 2.2 ml 0.5% hyperbaric bupivacaine solution and then heart rates, systolic blood pressure, diastolic blood pressure, mean arterial pressure were recorded every two and half minutes for ten minutes and then every five minutes for till end of surgery after. Hemodynamic parameters were compared with baseline in each group.Results: Change in mean, systolic and diastolic arterial pressure compared with baseline value were comparable in both the groups, but use of ephedrine as rescue vasopressor drug was significantly reduced in granisetron group. The episodes of hypotension, nausea/vomiting and shivering were comparable in both groups.Conclusions: Type 3 serotonin blockade by intravenous granisetron pre-treatment does not reduce spinal induced hypotension in parturient undergoing elective caesarean section; however there is reduction in need of rescue vasopressor.

scholarly journals Use of Granisetron for prevention of hypotension and bradycardia due to spinal anesthesia: A double blind randomised control trial

2015 ◽  
Vol 1 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Battu Kumar Shrestha ◽  
Subhash Prasad Acharya ◽  
Moda Nath Marhatta
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
Serotonin Receptors ◽  
Randomised Control Trial ◽  
Saline Control ◽  
Subarachnoid Block

Background: The common adverse effects of spinal anaesthesia include hypotension and bradycardia are due to sympathetic nerve blockade and activation of the Bezold-Jarisch reflex. The Bezold-Jarisch reflex in spinal anaesthesia may be mediated by peripheral 5-HT3 type serotonin receptors. We hypothesized that blockade of type 3 serotonin receptors by using intravenous Granisetron might reduce hypotension and bradycardia induced by spinal anaesthesia.Methodology: Sixty American Society of Anesthesiologists Physical Status I and II patients undergoing lower abdominal surgeries were randomized to receive either Normal Saline (control) or Granisetron 40 mcg/kg intravenously five minutes before subarachnoid block. Heart rates, systolic blood pressure, diastolic blood pressure, mean arterial pressure was recorded every two minutes for ten minutes and then every five minutes for another twenty minutes. Hemodynamic parameters were compared with baseline in each group.Results: There was decrease in all measured variables when compared with baseline values in both groups. There was less reduction in diastolic blood pressure in Granisetron group statistically significant at 10, 15, 20, 25 and 30 minutes. However, the less decrease in mean arterial pressure was statistically significant at 30 minutes only. There were no significant differences in systolic blood pressure and heart rate values between the groups.Conclusions: Granisetron given intravenously does not decrease the incidence of hypotension and bradycardia following subarachnoid block in patients undergoing lower abdominal surgery. However, it attenuates the fall of diastolic and mean arterial pressure spinal anaesthesia.Journal of Society of Anesthesiologists 2014 1(1): 36-39

scholarly journals TO COMPARE THE NEED FOR INTRAVENOUS VASOPRESSOR (RESCUE) THERAPY FOR TREATING SPINAL ANAESTHESIA INDUCED HYPOTENSION AMONG PHENYLEPHRINE, EPHEDRINE AND CONTROL GROUPS.

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Utsav Sharma ◽  
Kunwar Singh Thakur ◽  
Preeti Goyal ◽  
Bhanu Choudhary
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Rescue Therapy ◽  
Elective Caesarean Section ◽  
Control Group ◽  
Control Groups ◽  
Induced Hypotension ◽  
Medical College ◽  
And Control

The study was undertaken in the Department of Anaesthesiology, Gajra Raja Medical College, Gwalior. The study included 90 patients (age 20-35 years) undergoing elective caesarean section under spinal anaesthesia. Maximum hypotension was observed in control group. As compared to the control group, incidence of hypotension was significantly less in phenylephrine group as well as ephedrine group. Also comparing ephedrine and phenylephrine groups, although incidence of hypotension was low in phenylephrine group but it was not found to be significant. The incidence of hypotension was significantly low in phenylephrine group (p=0.000) and ephedrine group (p=0.005). But when phenylephrine and ephedrine groups were compared, although incidence of hypotension was low in phenylephrine group but it was not found to be significant (p=0.869). Keywords: Intravenous Vasopressor, Spinal Anaesthesia, Hypotension & Phenylephrine.

scholarly journals Blood pressure and cardiac output during caesarean delivery under spinal anaesthesia: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046102
Author(s):  
Trond Melbye Michelsen ◽  
Christian Tronstad ◽  
Leiv Arne Rosseland
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Cohort Study ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Prospective Cohort ◽  
Caesarean Delivery ◽  
Elective Caesarean Section ◽  
Secondary Outcome

ObjectivesWe have previously established a method to measure transfer of nutrients between mother, placenta and fetus in vivo. The method includes measurements of maternal and fetal blood flow by Doppler ultrasound prior to spinal anaesthesia. Spinal anaesthesia affects maternal blood pressure and cardiac output. We aimed to determine the effect of spinal anaesthesia in mothers undergoing an elective caesarean section on blood pressure, heart rate and cardiac output, and whether cardiac output levels were comparable before induction of spinal anaesthesia and before delivery.DesignProspective cohort study.SettingTertiary hospital in Norway.Participants76 healthy women with uneventful pregnancies undergoing an elective caesarean section.InterventionsWe induced spinal anaesthesia with a standard prevention of hypotension including intravenous fluid coloading and phenylephrine infusion.Primary and secondary outcome measuresPrimary outcome measure was maternal cardiac output, and secondary outcome measures were invasive systolic blood pressure and heart rate. We measured heart rate and blood pressure by continuous invasive monitoring with a cannula in the radial artery. Cardiac output was estimated based on continuous arterial waveform. We compared maternal parameters 30 s before induction of spinal anaesthesia to 30 s before delivery.ResultsMedian age at delivery was 34.5 (range 21–43) years and 17 of 76 women were nulliparous. The most prevalent indications were previous caesarean section and maternal request. Among 76 included women, 71 had sufficient data for analysis of endpoints. Median cardiac output was 6.51 (IQR (5.56–7.54) L/min before spinal anaesthesia and 6.40 (5.83–7.56) L/min before delivery (p=0.40)). Median invasive systolic blood pressure increased from 128.5 (120.1–142.7) mm Hg to 134.1 (124.0–146.6) mm Hg (p=0.014), and mean heart rate decreased from 86.0 (SD 13.9) to 75.2 (14.2) (p<0.001).ConclusionsMaternal cardiac output at the time of caesarean delivery is comparable to levels before induction of spinal anaesthesia.Trial registration numberNCT00977769.

scholarly journals Maternal hemodynamic effect of prophylactic glycopyrrolate after spinal anaesthesia for elective caesarean section

2021 ◽  
Vol 8 (1) ◽  
pp. 44-50
Author(s):  
Roshan Piya ◽  
Anil Shrestha ◽  
Manisha Pradhan ◽  
Shirish Amatya ◽  
Niroj Hirachan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Caesarean Section ◽  
Arterial Pressure ◽  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
Hemodynamic Effect ◽  
Group I ◽  
Group Ii

Introduction: Hypotension and bradycardia are the most common complications during spinal anesthesia. Bradycardia decreases cardiac output, resulting in hypotension and even cardiac arrest. Glycopyrronium, an anticholinergic drug increases heart rate and prevents bradycardia during spinal anesthesia by blocking the effects of acetylcholine on the sinoatrial node. The study aims to measure the maternal hemodynamic effect of glycopyrrolate after spinal anesthesia for elective caesarean section. Method: An intervention, comparative study was conducted in Patan Hospital after approval from Ethical Committee. Eighty-two pregnant women scheduled for elective caesarean section were randomly assigned in two groups by sealed envelope method; Group I received glycopyrrolate 0.2mg intravenous,  Group II did not receive glycopyrrolate. The patient’s heart rate, blood pressure, mean arterial pressure, a total dose of ephedrine, the occurrence of nausea, vomiting, and dry mouth were recorded. Independent-T test, chi-square test were used for statistical analysis. Result: Among 82 elective caesarean sections, 41 in each group, Group II (non-glycopyrrolate) reported increased heart rate compared to Group I (glycopyrrolate), but was statistically not significant. The highest recorded diastolic blood pressure was more in Group I compared to Group II and was statistically significant. The highest recorded Mean Arterial Pressure was high in the glycopyrrolate group and was statistically significant. The total dose of ephedrine was lower in the statistically significant glycopyrrolate group. The incidence of dry mouth was more in the glycopyrrolate group and the difference was statistically significant. Conclusion: Glycopyrrolate reduces the incidence of hypotension but not bradycardia and decreases the need for vasopressor.

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