Ondansetron and Spinal-Induced Hemodynamic Effects: What Anesthesia Providers Should Know

Ondansetron is a 5-HT3 serotonin antagonist that has been implicated in the attenuation of spinal-induced hypotension and bradycardia. Randomized control trials, systematic reviews, and meta-analysis studies showed that administration of prophylactic ondansetron five minutes prior to the placement of a subarachnoid block, or spinal anesthetic, resulted in a decreased incidence of hypotension and bradycardia among parturients. One of the leading causes of complications during a cesarean section is directly related to the hemodynamic changes seen with a spinal anesthetic. The use of ondansetron can lead to increased patient safety and is a cost-effective measure in maintaining stable hemodynamics. The purpose of this project was to educate student registered nurse anesthetists (SRNAs) attending Advent Health University (AHU) on the benefits of intravenous ondansetron to attenuate spinal-induced hypotension and bradycardia. For discussion purposes, a literature review was conducted by searching multiple databases in which an educational and comprehensive PowerPoint was derived and presented to the SRNAs at AHU. A pre- and posttest consisting of ten multiple-choice questions were disseminated and collected from the twenty-two SRNAs. The data was analyzed and assessed for advancement of knowledge among the students using a paired sample t-test in an SPSS software program. The mean scores increased from pretest (75%) to posttest (97%). The paired samples test results indicated an educational PowerPoint was successful in increasing the knowledge base amongst SRNAs on the use of intravenous ondansetron to attenuate spinal induced hemodynamic effects (t = -6.087, p < .001). This is pertinent to our practice as implementing ondansetron into a spinal anesthetic plan is crucial to improve patient outcomes and enhance safety.