Ephedrine Versus Ondansetron in the Prevention of Hypotension During Cesarean Delivery: A Randomized, Double-blind, Placebo-controlled Trial

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(Int J Obstet Anesth. 2016;27:25–31)Maternal hypotension is a common complication of spinal anesthesia for cesarean delivery. This can lead to bothersome side effects such as nausea and vomiting as well as more serious consequences like fetal hypoxia and acidosis. Phenylephrine and ephedrine are typically administered for the prevention and/or treatment of spinal-induced hypotension. However, some studies in the past few years have shown that ondansetron, a serotonin (5-HT3) receptor antagonist, was effective at preventing spinal-induced hypotension. It has been hypothesized that ondansetron prevents hypotension by inhibition of the Bezold-Jarisch reflex. This current randomized, double-blind study compared the efficacy of ephedrine and ondansetron for the prevention of maternal hypotension in parturients receiving spinal anesthesia for elective cesarean delivery.

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