INTRAVENOUS ONDANSETRON VERSUS GRANISETRON ON HEMODYNAMIC CHANGES INDUCED BY SPINAL ANESTHESIA IN ELDERLY PATIENTS UNDERGOING LOWER LIMB SURGERIES

Abstract

Background Although spinal anesthesia avoids the risks of airway management in elderly patients,
but hemodynamic instability as hypotension and bradycardia still the major complications of spinal
anesthesia. Ondansetron and granisetron are selective serotonin receptor antagonists used mainly as
antiemetics and may have a role to decrease the hemodynamic instability.
Methods : Randomized controlled double blind clinical study included 72 Patients of age 65 years or
above undergoing lower limb surgeries under spinal anesthesia were randomly allocated into 3 equal
groups (24 patients each), group O (ondansetron) received I.V 8mg ondansetron group G (granisetron)
received I.V 1mg granisetron, group S (control group) received 10 ml I.V normal saline 5 minutes
before induction of spinal anesthesia. Hypotension and bradycardia were recorded.
Results: There were statistically significant decrease in the number of patients developed
hypotension (P value 0.011) and bradycardia (P value 0.001) in the O and G groups compared to the
control group with no difference between the O and G groups.
Conclusions: In elderly patient undergoing lower limb surgeries under spinal anesthesia, prophylactic
intravenous administration of 8mg ondansetron or 1mg granisetron 5 minutes before induction of
spinal anesthesia reduces the hemodynamic instability with no significant difference between the two
drugs.