Granisetron reduces the need for uterotonics but not sympathomimetics during cesarean delivery1. Issue 3 (15th April 2019)

• Record Type: Journal Article
• Authors: Raimann, Florian J.; Baldauf, Henrica P.; Louwen, Frank; Jennewein, Lukas; Fischer, Dania; Zacharowski, Kai; Weber, Christian F.
• Is Part Of: International journal of gynaecology and obstetrics. Volume 145:Issue 3(2019)
• Page Start: 361
• Page End: 366
• Publication Date: 2019-04-15
• Subjects: 5‐Hydroxytryptamine‐3 receptor -- Cesarean delivery -- Granisetron -- Hypotension -- Retrospective study -- Spinal anesthesia -- Sympathomimetics; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.12819
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To assess the effect of a 5‐hydroxytryptamine‐3 receptor antagonist (granisetron) on the use of sympathomimetic (cafedrine/theodrenaline) and uterotonic (oxytocin) agents after spinal anesthesia during cesarean delivery. Methods: A retrospective observational analysis was conducted using intraoperative records (n=240) created at a single hospital in Germany between November 1, 2016, and July 31, 2017. The granisetron group (n=120) had received 3 mg of granisetron immediately before induction of spinal anesthesia. The control group (n=120) had not received granisetron. The primary endpoints were the intraoperative requirements for sympathomimetic and uterotonic agents. The secondary endpoints were parameters of intraprocedural maternal hemodynamic and clinical states. Results: More patients in the granisetron group than in the control group received intraoperative cafedrine/theodrenaline ( P =0.045), with the cumulative intraoperative dosage also increased in the granisetron group ( P =0.016). By contrast, the cumulative intraoperative dose of oxytocin was lower in the granisetron group than in the control group ( P <0.001). Decreases in heart rate and mean arterial blood pressure were lower in the granisetron group versus the control group ( P =0.015 and P =0.002, respectively). Conclusion: Treatment with granisetron immediately before cesarean delivery did not reduce the perioperative requirement for sympathomimetics but did reduce the need for uterotonics. Registered at ClinicalTrials.gov (NCT03318536): Abstract : Granisetron did not reduce the need for perioperative sympathomimetics during cesarean delivery under spinal anesthesia; however, lower doses of uterotonics were necessary to preserve hemodynamic stability.