Dissertation
Ondansetron and its use in preventing spinal anesthesia-induced hypotension
Doctor of Nursing Practice (D.N.P.), Drexel University
09 Mar 2025
DOI:
https://doi.org/10.17918/etd-4122
Abstract
Spinal anesthesia is a common alternative to general anesthesia for perineal, lower abdominal, and lower extremity procedures. It benefits the patient by maintaining spontaneous negative pressure ventilation, complete surgical akinesia, and analgesia. However, spinal anesthesia has risks, including spinal anesthesia-induced hypotension. It is believed that the sympathectomy associated with spinal anesthesia-induced hypotension can induce the Bezold-Jarisch reflex through the intracardiac serotonin pathway, which can lead to further deterioration of hemodynamics. Recent literature has targeted this clinical problem, and there is overwhelming evidence that administering ondansetron at least 5 minutes before the injection of spinal anesthesia can prevent spinal anesthesia-induced hypotension. This project aimed to educate anesthesia providers (anesthesiologists, certified registered nurse anesthetists, and student registered nurse anesthetists) at a large tertiary care clinical site on the literature to decrease the incidence of spinal anesthesia-induced hypotension. During project implementation, an educational PowerPoint presentation was used to disseminate the evidence-based literature to analyze if education increased the likelihood of providers utilizing ondansetron before administering a spinal anesthetic. A Likert scale pre-and post-survey was distributed, with 45 anesthesia providers completing the pre-survey and 40 providers completing the post-survey. A pre- and post-intervention chart review was also conducted. Data analysis revealed clinical and statistical significance in favor of the education intervention. Therefore, clinical education should be a part of quality improvement projects to foster evidence-based practice. Keywords: ondansetron, spinal anesthesia, Bezold-Jarisch reflex, spinal anesthesia-induced hypotension
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Details
- Title
- Ondansetron and its use in preventing spinal anesthesia-induced hypotension
- Creators
- Christopher CarrollScott Schultz
- Contributors
- Dawn M. Specht (DNP Chair) - Drexel University, Nurse Practitioner Master of Science in Nursing (MSN)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Nursing Practice (D.N.P.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- 56 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Nurse Anesthesia; Nursing (Graduate); College of Nursing and Health Professions; Drexel University
- Other Identifier
- 991014632162804721