Citation: Mohammad Moinul Islam, Muhammad Khairul Bashar, Md. Ariful Hoque, Moazzem Hossain, Suhel Ahmed, Esrat Zahan Sunzee. Ondansetron as Prophylactic against Hypotension and Bradycardia Following Spinal Anaesthesia in Elective Caesarean Section: a Case Control Study. Sch J App Med Sci, 2022 Apr 10(4): 500-505. 500 Scholars Journal of Applied Medical Sciences Abbreviated Key Title: Sch J App Med Sci ISSN 2347-954X (Print) | ISSN 2320-6691 (Online) Journal homepage: https://saspublishers.com Ondansetron as Prophylactic against Hypotension and Bradycardia Following Spinal Anaesthesia in Elective Caesarean Section: a Case Control Study Mohammad Moinul Islam 1* , Muhammad Khairul Bashar 2 , Md. Ariful Hoque 3 , Moazzem Hossain 4 , Suhel Ahmed 5 , Esrat Zahan Sunzee 6 1 Assistant Professor, Department of Anesthesia, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh 2 Assistant Professor, Department of Anesthesia, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh 3 Junior Consultant, Department of Anesthesia, Feni 250 bed District Sadar Hospital, Feni, Bangladesh 4 Chairman, Department of Anesthesia, Institute of Allergy and Clinical Immunology of Bangladesh, Dhaka, Bangladesh 5 Junior Consultant, Department of Anesthesia, Sunamgonj 250 bed District Sadar Hospital, Sunamgonj, Bangladesh 6 Junior Consultant, Department of Anesthesia, Matiranga Upazila Health Complex, Khagrachori, Bangladesh DOI: 10.36347/sjams.2022.v10i04.010 | Received: 24.02.2022 | Accepted: 26.03.2022 | Published: 11.04.2022 *Corresponding author: Dr. Mohammad Moinul Islam Assistant Professor, Department of Anesthesia, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh Abstract Original Research Article Introduction: Hypotension and bradycardia following the administration of spinal anesthesia for cesarean section are very common and bear profound detrimental effects both on mother and baby. In our country, a significant proportion of patients undergo cesarean section delivery. Considering the workload and the socio-economic condition it is often a bad headache for our anesthesiologists to combat post-spinal hypotension. Vasopressor drugs have been widely used to prevent and treat maternal hypotension during cesarean section under spinal anesthesia. A combination of preloading and using vasopressor has maximum efficacy in preventing spinal-induced hypotension but with compromising with some detrimental adverse effects of vasopressor. Amongst vasopressors, ephedrine is widely used but studies found that a higher bolus dose is often required to prevent hypotension and bradycardia. Aim of the study: To find out the efficacy of ondansetron to prevent haemodynamic derrangement in cesarean section under spinal anaesthesia. Methods: This Prospective Randomized Double-Blind Comparative study was conducted at the Department of Anesthesiology and ICU, Dhaka Medical College Hospital, Dhaka, Bangladesh. The study duration was ten months, from March 2015 to January 2016. A total of 120 participants were randomly included in this study.Each participant was included either into “Group A (n=60)” or “Group B (n=60)” by using fixed number card sampling as mentioned earlier. Group B had been considered as control group in the study, Participants of group A received intravenous ondansetron (0.1 mg/kg body weight) and group B received ephedrine (0.5 mg/kg body weight). Result: The majority of the participants (58.33%) from both groups were from the age group of 26-30 years. Parity distribution revealed that 59.17% (n=71) patients were multigravida while 40.33% (n=49) were primi. In total, 80.33% of the participants had ASA I physical status, and 19.17% had ASA II. All patients were scheduled for elective cesarean section and the highest number of them (49.17%; n=59) had a history of cesarean section for their previous delivery. The next highest indication was malpresentation (14.17%; n=17) and the least was short stature (1.67%; n=02). There was no significant difference between the groups as regards Pre-anesthesia MAP (p=0.883), but after induction of spinal anesthesia significant decrease in MAP was seen in all groups compared with basal MAP, the least decrease occurring in group A and the highest fall in the group B. Although shivering was common for both groups, the occurrence of nausea and vomiting was significantly less in group A. P values for nausea and vomiting were statistically significant (p<0.05) between two groups. Conclusion: The efficacy of Ondansetron in attenuation of hemodynamic derangements following spinal anesthesia has been proven to be satisfactory with statistically significant supremacy of Ondansetron over Ephedrine. Besides this Ondansetron bears additional advantages in the management of perioperative nausea and vomiting, although proved less effective to prevent shivering. Keywords: Spinal Anesthesia, Cesarean Section Prophylactic, Ondansetron, Ephedrine. Copyright © 2022 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited. Anesthesiology