Review of Literature

Several common themes were identified within the literature regarding the effects of prophylactic ondansetron on post-spinal hemodynamics, including attenuation of hypotension, limited to no efficacy in decreasing the incidence of bradycardia, and reduced vasopressor use.

Key Terms

For the purposes of this doctoral project proposal, the following terms are defined: subarachnoid block, prophylaxis, hypotension, bradycardia, Bezold-Jarisch reflex, and ondansetron.

Search Process

To gather data concerning ondansetron’s effect on post-spinal hemodynamics, a search was conducted of the following databases: PubMed, OVID, CINHAL, and Google Scholar.

Strength of the Evidence

To determine the strength of evidence for each research article, we used the Johns Hopkins Nursing Evidence-based Practice: Levels of Evidence and Quality Guide. We found 24 studies deemed level I evidence..

Attenuation of Hypotension

Ondansetron’s efficacy in mitigating hypotension before SAB is a recurrent theme within the literature. We found 18 studies indicating some degree of statistical significance.

Incidence of Bradycardia

The sympathectomy occurring in patients receiving SAB frequently results in a decrease in blood pressure and heart rate. The bradycardia that may occur post-spinal has a reported incidence of 13%...

Decreased Vasopressor Administration

Reduced vasopressor consumption in patients receiving ondansetron prior to SAB was a major theme within the literature, and is likely attributed to reductions in the prevalence and severity of hypotension.