Effect of ondansetron on post-dural puncture headache (PDPH) in parturients undergoing cesarean section: a double-blind randomized placebo-controlled study

Fattahi, Zainabosadat; Hadavi, Seyed; Sahmeddini, Mohammad
October 2015
Journal of Anesthesia;Oct2015, Vol. 29 Issue 5, p702
Academic Journal
Purpose: 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-HT 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). Conclusion: 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.


Related Articles

  • Effect of acupuncture on nausea and/or vomiting during and after cesarean section in comparison with ondansetron. El-Deeb, Alaa; Ahmady, Mona // Journal of Anesthesia;2011, Vol. 25 Issue 5, p698 

    Purpose: Acupuncture has been used for the management of postoperative nausea and vomiting (PONV). This study compared the effect of electrical acustimulation with ondansetron for preventing intraoperative and postoperative emetic symptoms and improving patient satisfaction. Methods: After...

  • A case of accidental intrathecal injection of a large dose of ropivacaine during cesarean section. Yan P Yuan; Hong F Chen; Chen Yang; Fu B Tian; Shao Q Huang // International Journal of Clinical & Experimental Medicine;2014, Vol. 7 Issue 8, p2383 

    Continuous spinal anesthesia may provide excellent labor analgesia. The incidence of accidental intrathecal injection of megadose of ropivacaine, as one of the possible complications during cesarean section, is very rare. Present case report provides reference to clinical practice.

  • Vasovagal cardiac arrest during spinal anesthesia for Cesarean section. Jang, Young-Eun; Do, Sang-Hwan; Song, In-Ae // Korean Journal of Anesthesiology;Jan2013, Vol. 64 Issue 1, p77 

    The vasovagal response is characterized by an inappropriate combination of bradycardia and paradoxical vasodilation. During a general or neuraxial anesthesia-induced sympathectomy, a sudden vagal activation and/or an acute reduction in sympathetic tone can cause serious vasovagal responses....

  • Efficacy of prophylactic intravenous ondansetron on the prevention of hypotension during cesarean delivery: a dose-dependent study. Meng Wang; Lang Zhuo; Qun Wang; Ming-Kun Shen; Yan-Yun Yu; Jun-Jing Yu; Zhi-Ping Wang // International Journal of Clinical & Experimental Medicine;2014, Vol. 7 Issue 12, p5210 

    Objective: This study was to determine the optimal dosage of ondansetron for preventing maternal hypotension during cesarean delivery. Methods: One hundred and fifty parturient women scheduled for elective cesarean section were randomly assigned to five groups (n=30). Five minutes prior to...

  • Right Sided Chest Pain After Spinal Anesthesia; A Case Report. Gök, Funda; Apilioğulları, Seza // Journal of the Turkish Anaesthesiology & Intensive Care Society ;Jan2009, Vol. 37 Issue 1, p52 

    We report a postural chest wall pain without headache after spinal anesthesia. A 36-year old woman presented for elective cesarean section. Spinal anesthesia was achieved on the third attempt with 25-G Quincke needle. Right sided, postural chest pain and neck stiffness developed over 12 hours....

  • Incidence and risk factors for chronic pain after caesarean section under spinal anaesthesia. SNG, B. L.; SIA, A. T. H.; QUEK, K.; WOO, D.; LIM, Y. // Anaesthesia & Intensive Care;Sep2009, Vol. 37 Issue 5, p748 

    The article examines the incidence of chronic pain after elective caesarean section under spinal anesthesia in an Asian population. Chronic incision site pain was experienced by one-third of patients having Pfannenstiel incisions. The entrapment of the lower abdominal wall nerve supply is...

  • Fatal Necrotising Fasciitis After Spinal Anaesthesia. Singh, Raj Kumar; Dutta, Gautam // Journal of Cutaneous & Aesthetic Surgery;Jul2013, Vol. 6 Issue 3, p165 

    The article presents a case study of a 27-year-old woman who is suffering from complications of spinal anaesthesia which she received before undergoing a caesarean section delivery. It describes the patient's appearance and physical condition whose entire back is discolored and is suffering from...

  • A comparison of three vasopressors for tight control of maternal blood pressure during cesarean section under spinal anesthesia: Effect on maternal and fetal outcome. Bhardwaj, Neerja; Jain, Kajal; Arora, Suman; Bharti, Neerja // Journal of Anaesthesiology Clinical Pharmacology;Jan2013, Vol. 29 Issue 1, p26 

    Purpose: Maintaining systolic blood pressure (SBP) at 100% of baseline is best for fetal and maternal outcome. We hypothesized that irrespective of the vasopressor used, maintaining SBP at 100% of baseline with phenylephrine (P), metaraminol (M), or ephedrine (E) will produce the best fetal pH...

  • Comparison of different doses of clonidine as an adjuvant to intrathecal bupivacaine for spinal anesthesia and postoperative analgesia in patients undergoing caesarian section. Bhushan, Shah Bhavini; Suresh, Joshi Smita; Vinayak, Shidhaye Ramchandra; Lakhe, J. N. // Anaesthesia, Pain & Intensive Care;Sep-Dec2013, Vol. 16 Issue 3, p266 

    Background: The necessity to find out the lowest possible effective dose of clonidine to avoid its known side effects like hypotension, bradycardia and sedation prompted us to design present study. We compared different doses of clonidine as an adjuvant to intrathecal bupivacaine for spinal...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics