Practice Considerations for Perioperative Ondansetron Use in Parturients Undergoing Cesarean Sections with Spinal Anesthesia

Elective cesarean sections are often performed with spinal anesthesia, a form of neuraxial anesthesia that offers superior pain relief and reduces the risks associated with general anesthesia. However, over 50% of parturients experience side effects from spinal anesthesia, including shivering, hypotension, nausea, and vomiting, which can cause both physiological and psychological issues for the laboring mother and be detrimental to the fetus. Preventing these side effects is vital for improving safety, patient satisfaction, and minimizing complications. While various interventions and medications have been explored to manage these effects, no standardized guidelines exist for their prevention. A review of existing literature highlights the effectiveness of ondansetron in reducing post-spinal anesthesia complications, particularly for women undergoing non-emergent cesarean sections. This proposed final scholarly project addresses the lack of standardized, evidence-based practice (EBP) guidelines by proposing perioperative dosing recommendations for ondansetron. The Johns Hopkins EBP Model will be used as the framework for this project, which employs a quantitative approach to assess the impact of the practice in an academic center with a comprehensive obstetrics unit in central Ohio. While the project aims to develop an evidence-based framework for practice, it is currently not being implemented. The implementation plan spans approximately nine months, including a literature review, data collection, and evaluation. The expected outcomes include a reduction in post-spinal anesthesia side effects such as shivering, hypotension, nausea, and vomiting. This intervention is anticipated to reduce complications, improve maternal and fetal health, lower healthcare costs, and shorten hospital stays.