ABSTRACT
Objective: Hypotension is the commonest side effect associated with spinal anesthesia. Multiple modalities have been tested to find adequate preventive measure. Main objective of this study is to find out the effectiveness of prophylactic administration of inj. ondansetron for prevention of spinal anesthesia induced hypotension in elderly patients
Study design: Double blind, randomized controlled trial
Place and duration of study: This study was conducted in our anesthesiology department from 01 July 2014 to 31 December 2014
Methodology: 100 patients were selected for the study using non-probability sampling technique, and divided into two groups of 50 each using random numbers table. Each patient was preloaded with ringer's lactate solution in a dose of 10 ml/kg Patients of Group A received 8 mg of ondansetron IV five minutes prior to administration of spinal anesthesia; whereas patients of Group B were injected normal saline IV. Data were collected and analyzed using IBM SPSS version 20. Chi square test was used to compare hypotension between two groups. A p-value < 0.05 was taken as significant
Results: Mean age of Group A was 64.16 +/- 8.47 years, whereas that of Group B was 62.58 +/- 8.99 [p value= 0.39]. Mean weight of Group A was 72.64 + 5.82 kg, whereas that of Group B was 70.66 + 5.96 kg [p = value p- 0.295]. Hypotension was present in 23 [46%] patients in Group A, where as it was present in 34 [68%] patients in Group B [p value= 0.026]. Bradycardia was recorded in 3[06%] vs. 11 [22%] patients in Group A and B respectively [p=0.021]
Conclusion: We conclude that intravenous administration of 8 mg of ondansetron, 5 minutes prior to subarachnoid block, is effective in decreasing frequency of hypotension and bradycardia in elderly patients
ABSTRACT
Snake bite is quite common in most of the countries of the world, especially tropics and subtropical areas. The snake venom is usually one of the two types; neurotoxins and hemotoxins or hemolysins. The management of snake bite consists of supportive treatment and anti-snake venom serum. The patients suffering from respiratory problems due to muscular paralysis will require mechanical ventilatory support. We present a case of a victim of black mamba bite, which is one of the most dreaded snakes in Africa. His recovery was slow and marred with coagulation profile derangement. Finally we started neostigmine and atropine and witnessed a dramatic improvement in his muscle power. He rapidly improved and was discharged with complete recovery