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العنوان
Intravenous Ondansetron for Attenuation of Post Spinal Anesthesia Hypotension/
المؤلف
Ahmed,Hazem Mohamed Sabry Abdel Aziz
هيئة الاعداد
باحث / حازم محمد صبرى عبد العزيز احمد
مشرف / احمد سعيد محمد ابراهيم
مشرف / رانيا محروس على حسين
تاريخ النشر
2020
عدد الصفحات
118.p:
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
التخدير و علاج الألم
تاريخ الإجازة
13/2/2020
مكان الإجازة
جامعة عين شمس - كلية الطب - Anaesthesia, Intensive Care and Pain Management
الفهرس
Only 14 pages are availabe for public view

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from 118

Abstract

Spinal Anesthesia is a common type of anesthesia used during many surgical procedures. This regional technique can be accomplished by administering an intrathecal dose of hyperbaric local anesthetic solution. The local anesthetic within the subarachnoid space can block sensory, motor and sympathetic pathways.
One of the most common complications associated with spinal anesthesia is hypotension with or without bradycardia that can increase risk of perioperative cerebral and cardiovascular events.
The postulated mechanism for hypotension has been attributed to both venous and arterial vasodilatation resulting from a local anesthetic induced sympathetic blockade, while bradycardia is believed to result from an increase in parasympathetic tone, blockade of the cardioaccelerator nerve fibers, and decreased baroreceptor activity. Recently, the Bezold Jarisch reflex (BJR) has been implicated as the most likely cause of bradycardia following spinal anesthesia.
The Bezold–Jarisch reflex is a cardioinhibitory reflex producing bradycardia, hypotension, and cardiovascular collapse via non-myelinated, type C fibers whose terminals lie in the chambers ofthe heart. Stimulation of peripheral serotonin receptors 5-hydroxytryptamine (5-HT3) elicits the BJR.
Ondansetron is a potent, highly selective serotonin (5-HT3) receptor antagonist. It can prevent the combination of 5-HT released by activated platelets with 5-HT3 receptors in the vagal nerve endings of the left ventricle, attenuate Bezolde Jarisch reflexes produced by left ventricular mechanoreceptors stimulated by 5-HT, inhibit further expansion of peripheral blood vessels, and increase venous return, thereby reducing the incidence of hypotension.
The Purpose of this study was to find out the effectiveness of prophylactic administration of intravenous ondansetron for attenuation of spinal anesthesia induced hypotension in non-obstetric spinal anesthesia surgeries.