Anesth Pain Med.  2016 Apr;11(2):195-200. 10.17085/apm.2016.11.2.195.

Palonosetron might not attenuate spinal anesthesia-induced hypotension during orthopedic surgery

• Choi JJ
• Chang YJ
• Jung WS
• Jo YY

• KMID: 2358485
• DOI: http://doi.org/10.17085/apm.2016.11.2.195

Abstract

BACKGROUND
5-Hydroxytryptamine3 (5-HT3) receptor antagonists have been reported to attenuate spinal anesthesia-induced hemodynamic changes. This study was conducted to determine whether the second generation 5-HT3, antagonist palonosetron attenuates hypotension and bradycardia during spinal anesthesia.
METHODS
Sixty adult patients scheduled for lower limb surgery were enrolled in this study. Patients were randomly assigned to receive either normal saline (Control group, N = 30) or palonosetron (0.075 mg, i.v.) (Palonosetron group, N = 30) prior to spinal anesthesia. Hemodynamic variables were recorded during anesthesia.
RESULTS
The mean blood pressure (MBP) were 89.2 ± 11.4 mmHg in the control group and 87.6 ± 12.1 mmHg in the palonosetron group at 10 min after intrathecal injection (P = 0.609). The median blocked levels of the control group and the palonosetron group were T10 (interquartile range, 9-10) and T10 (8-10) at 20 min after intrathecal injection (P = 0.939). Requirements for ephedrine, phenylephrine, and atropine were similar (P = 0.652, 0.533 and 0.417, respectively). The incidences of hypotension (40% vs. 41%) and bradycardia (7% vs. 17%) were comparable (P = 0.562, P = 0.198, respectively) between the control and the palonosetron group. There were no significances in the changes of systolic blood pressure, diastolic blood pressure, MBP and heart rate by the group (P = 0.632, 0.287, 0.556, 0.733, respectively).
CONCLUSIONS
Intravenous palonosetron (0.075 mg) prior to spinal anesthesia might not attenuate spinal anesthesia-induced hypotension during low level of neuroaxial block for lower limb surgery.

Keyword

Hypotension; Palonosetron; Spinal anesthesia

MeSH Terms

Adult
Anesthesia
Anesthesia, Spinal
Atropine
Blood Pressure
Bradycardia
Ephedrine
Heart Rate
Hemodynamics
Humans
Hypotension*
Incidence
Injections, Spinal
Lower Extremity
Orthopedics*
Phenylephrine
Atropine
Ephedrine
Phenylephrine

Figure

• 

  Fig. 1 Peri-operative changes in systolic and diastolic blood pressures, mean blood pressure, and heart rate in patients that received normal saline (Control group) or palonosetron (Palonosetron group) during spinal anesthesia. Error bars represent with standard deviations. T0: Before anesthesia induction, T1: 1 min after intrathecal injection, T5–T40: Every 5 min after intrathecal injection (from 5 min to 40 min after intrathecal injection).

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