Efficacy of Ondansetron as a Prophylactic Anti-Hypotensive Pharmacologic Intervention Among Obese Parturients Undergoing Spinal Anesthesia for Cesarean Delivery

Background and PurposeObesity has been identified as a risk factor for hypotension after spinal anesthesia among parturients undergoing cesarean delivery. Although researchers have demonstrated prophylactic administration of ondansetron as efficacious in attenuating maternal hypotension following spinal anesthesia, no studies have examined the efficacy of prophylactic ondansetron in the high risk population of obese parturients. The primary objective of this study was to assess the efficacy of the novel application of ondansetron as a prophylactic anti-hypotensive pharmacologic intervention among obese parturients in order to facilitate practice recommendations that aim to reduce maternal-fetal risk associated with the administration of spinal anesthesia for cesarean delivery. MethodsRetrospective chart analyses of 46 patients with BMI > 30 were conducted between August 1, 2014 and May 10, 2015 to determine whether the intravenous administration of 4 mg ondansetron prior to the induction of spinal anesthesia reduced frequency of vasopressor administration during cesarean section. ResultsThe incidence of vasopressor administration among patients who received prophylactic ondansetron was 35.7%, whereas 46.9% of patients who did not receive prophylactic ondansetron required vasopressor administration (χ2 = 0.144, df = 1, p = 0.704).ConclusionsObese parturients undergoing spinal anesthesia for cesarean delivery demonstrated improvements in hemodynamic stability when prophylactically treated with ondansetron.