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

Melissa Dawn Hudson, DNP, MSNA, CRNA, APRN; Neva L Crogan, Ph.D, ARNP, GNP-BC, FNGNA, FAAN; Edward J Bilsky, PhD

Melissa Dawn Hudson, DNP, MSNA, CRNA, APRN Gonzaga University http://orcid.org/0000-0002-4269-9521
Neva L Crogan, Ph.D, ARNP, GNP-BC, FNGNA, FAAN Gonzaga University
Edward J Bilsky, PhD University of New England

Abstract

Background and Purpose

Obesity 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.

Methods

Retrospective 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.

Results

The 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).

Conclusions

Obese parturients undergoing spinal anesthesia for cesarean delivery demonstrated improvements in hemodynamic stability when prophylactically treated with ondansetron.

Author Biographies

Melissa Dawn Hudson, DNP, MSNA, CRNA, APRN, Gonzaga University

Melissa D. Hudson, CRNA, APRN, MSNA, DNPc received her BSN from Washington State University Honors College in 2004 and her MSNA from the University of New England in 2008. She is a candidate for the degree of Doctor of Nursing Practice at Gonzaga University and a practicing nurse anesthetist at a critical access hospital in rural Washington State.

Neva L Crogan, Ph.D, ARNP, GNP-BC, FNGNA, FAAN, Gonzaga University

Neva Crogan, Ph.D., GNP-BC, ENGNA, FAAN received her BSN from the University of the State of New York in 1983, a Master’s in Nursing from Eastern Washington University in 1992 and a PhD from Washington State University in 1998. Her post-doctorate education includes a Geriatric Nurse Practitioner Certificate in 2007 from the University of Virginia. She is a Fellow of the American Academy of Nursing and was the co-recipient of the 2013 Sigma Theta Tau International Research Utilization Award. She has published more than 60 data based research articles and has presented at multiple regional, national and international conferences.

Edward J Bilsky, PhD, University of New England

Edward J. Bilsky, Ph.D., currently serves as the Vice President for Research and Scholarship at the University of New England. He received his B.S. (physics) in 1989 and M.S. (Behavioral Neuroscience) in 1991 from Rensselaer Polytechnic Institute. He earned a Ph.D. in Pharmacology and Toxicology from the University of Arizona Colleges of Medicine and Pharmacy in 1996. Dr. Bilsky is currently a tenured Professor of Pharmacology and is the Founding Director of the Center of Excellence in Neuroscience. He has served as the chair of the University of New England Faculty Assembly and is an Associate Editor for Life Sciences, a journal publishing research in the biomedical sciences. He was recently awarded the 2011 AOA Research Mentor of the Year Award.

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

Abstract

Author Biographies

References

Keywords