Attenuation of spinal anesthesia induced hypotension with granisetron in type I diabetic parturients: A randomized controlled clinical trial

Background This study aimed to assess the safety and efficacy of intravenous granisetron as adjuvant therapy for spinal anesthesia-induced hypotension in type I diabetic parturients undergoing CS.Methods This double-blinded, parallel-group, randomized trial enrolled 68 adult parturients who were scheduled for CS under spinal anesthesia. The patients were randomly allocated to two groups (34 parturients each). In the granisetron (G) group, 1 mg of granisetron diluted in 10 mL of normal saline was administered intravenously 10 minutes prior to spinal anesthesia. While in the control (C) group, 10 mL of normal saline was administered in the same manner. The primary outcomes were total ephedrine consumption and frequency of use. Secondary outcomes included the total atropine consumption and frequency of use, nausea, vomiting, estimated intraoperative blood loss, patient satisfaction, Apgar score, and hemodynamic parameters.Results Group G had a significant reduction in the total ephedrine consumption (P = 0.009) and its frequency of use (P = 0.034). While the total atropine consumption and frequency of use, intraoperative blood loss, and patient satisfaction were not significantly different between the two groups. Nausea and vomiting were significantly reduced in group G. After 5 minutes of delivery, the Apgar score was significantly elevated in group G. The reduction of heart rate and hypotension was significantly lowered in group G.Conclusion In type I diabetic parturients, prophylactic use of granisetron can be effective in reducing ephedrine usage and attenuating the spinal anesthesia-induced hypotension during CS.