A Double Blind Randomized, Placebo Controlled Study Evaluating the Effect of Ondansetron in Reducing Spinal- Induced Hypotension Using Low Dose Bupivacaine in Parturients Undergoing Caesarean Section.

Background: Spinal induced hypotension is the most common intraoperative complication after spinal anesthesia during cesarean delivery. Various adjuvant techniques/drugs had been used in the past to minimize the haemodynamic effects of spinal anaesthesia. Five-hydroxytriptamine (5-HT), a serotonergic receptor, may be an important factor associated with inducing the Bezold Jarish reflex (BJR) that may lead to the bradycardia and hypotension in the setting of decreased blood volume. Some animal and human studies further supported that BJR can be decreased by 5-HT3 antagonists. Aim: The present study work is to assess the effects of Inj. Ondansetron (a selective 5‑HT3 receptor antagonist) in preventing spinal induced hypotension in patient undergoing elective Caesarean section. Methods: Sixty parturients scheduled for elective caesarean section were randomly allocated into two groups. Group O (30 patients): Inj. Ondansetron (4 mg IV) diluted in 10 mL of normal saline, administered 5 minutes before spinal anaesthesia and Group N (30 patients): Normal saline 10 mL given 5 minutes before spinal anaesthesia. We observed the haemodynamic parameters as our primary outcome and neonatal outcome in terms of APGAR scoring as secondary outcome. Results: Both the groups were comparable in terms of demographic characteristics. The decrease in mean arterial pressure in Group O was significantly lesser than Group N from 6 min until 30 min. The requirement of vasopressor (Inj. Phenylephrine) was significantly less in Group O than Group N (P = 0.015). Neonatal outcome in terms of APGAR Score and gas analysis were comparable between the groups. Conclusion: Inj. Ondansetron (4 mg IV), given intravenously 5 min before subarachnoid block reduced hypotension and vasopressor use in parturients undergoing elective caesarean section.

Anatomical parameters of Neck; Predictors for Laryngoscopy and Intubation.

One of the common problems encountered by anaesthetists is difficult airway. Proper laryngoscopy and intubation is required by the anaesthetists for securing the airway by endotracheal tube. Anatomic parameters of the neck may prove to be a better predictors of airway particularly in difficult airway scenarios.

Use of Airtraq Optical Laryngoscope for Naso-Tracheal Intubation in Anaesthetized Patients.

Reported is a case of successful Nasotracheal intubation using Airtraq optical laryngoscope in a patient of fracture zygomatic arch with cervical spine injury. Th e patient had predicted diffi cult direct laryngoscopy with restricted mouth opening.

Localized Urticaria with Intravenous Ondansetron: A Case Report.

Ondansetron is an eff ective antiemetic agent widely used to control nausea and vomiting associated with malignancy and surgery. Although hypersenstivity reactions have been reported with ondansetron in connection with emetogenic chemotherapy, it has been rarely addressed under perioperative settings. Th is case highlights the need of increased awareness among anaesthesiologists regarding the allergic potential of ondansetron and emphasize for judicious administration of this drug with adequate emergency backup.

Supraorbital Foramen - Morphometric Study and Clinical Implications in Adult Indian Skulls.

Introduction: Supraorbital foramen is an important site for various surgical and anesthetic procedures. Accurate localization of the foramen holds the key to success, although racial variations exist in various population groups. Th e study included the morphometry of supraorbital foramen and its location with respect to nearby anatomical landmarks. Methods: A total of 100 dry skulls (60 male and 40 female) were collected and observed for the study. Various parameters in the sagittal and transverse planes were noted from supraorbital foramen on both sides, together with its vertical and horizontal dimensions. In addition, the location of supraorbital foramen with respect to midline and frontozygomatic suture were noted. Results: Th e study of 100 adult skulls revealed that the SON (71% on right and 70% on left) was found more frequently than the SOF (29% on right and 30% on left).Th e distance between centre of SOF/SON and midline was found to be statistically signifi cant on right and left sides. Conclusions: Th is study makes possible the identifi cation of exact position of supraorbital foramen and also discuss its racial variation.

Comparison of ramosetron and ondansetron for control of post-operative nausea and vomiting following laparoscopic cholecystectomy.

Background: Post-operative nausea and vomiting (PONV) is common. 5HT 3 receptor antagonists are commonly used drugs for its prevention. A study was designed to compare the efficacy and safety of ramosetron and ondansetron in patients undergoing laparoscopic cholecystectomy (lap chole). Materials and Methods: A prospective randomized case controlled study was conducted at J. N. Medical College Hospital, Aligarh Muslim University, Aligarh, India, in patients who underwent lap chole following intravenous administration of ondansetron (4mg) or ramosetron (0.3mg) at the end of surgery, and efficacy as well as side effects of ondansetron and ramosetron was documented and compared. Results: One hundred and thirty adult females undergoing lap chole were studied - 65 patients in each of the two groups. In first 24 h after surgery, complete response (No PONV) was observed in 28 patients of the ondansetron group and in 32 patients of the ramosetron group (P>0.05). Complete response in the second 24 h after surgery was observed in 30 patients of the ondansetron group and in 45 patients of the ramosetron group (P<0.05). During the first and second 24 h, PONV requiring rescue antiemetic was significantly higher (P<0.05) in the ondansetron group as compared to the ramosetron group. Adverse drug effects in the post-operative period were observed in 11 and 8 patients in ondansetron and ramosetron groups respectively (P>0.05). Conclusion: Ramosetron was found safe and more effective antiemetic than ondansetron in patients undergoing lap chole.