Meta-Detect Summary

In the meta-analysis performed by Gao L et al, ten randomized clinical studies were reviewed to determine the effect of ondansetron in the prevention of hypotension after spinal anesthesia was initiated. The researchers used relative risk with a 95% confidence interval to analyze their outcomes. The meta-analysis suggests that spinal-induced hypotension, bradycardia, and amount of vasopressors needed were reduced with prophylactic ondansetron. However, Gao L et al recommends that further, stricter studies with larger sample size should be performed with a focus in obstetric patients.
A meta-analysis is considered a systematic review, which provides the highest level of evidence. The systematic review is relevant to the PICOT question in that helped determine that the administration of ondansetron can help decrease spinal-induced hypotension. The article had many strengths including the extensive method used to obtain the research studies, careful review of the quality of the clinical trials, and thorough statistical analysis to help determine significance of an outcome. Some weaknesses include no definitive definition of hypotension. Also,
Eighty parturients were randomly placed into four groups, with group 1 to receive normal saline 10 milliliters and groups 2, 3 and 4 to receive granisetron, ondansetron, and ephedrine, respectively. The medications were diluted in normal saline to total 10 milliliters and injected prior to spinal anesthesia. The trial showed that prophylactic administration of the three studied drugs decreased spinal-induced hypotension, nausea, and the amount of vasopressors needed. Granisetron was the only drug shown to improve recovery time of the sensory