Browsing by Author "Kolawole I.K"

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    Dose related effects of oral clonidine premedication on bupivacaine spinal anaesthesia.
    (college of Health Sciences, Makerere University, Uganda, 2018) Adegboye, M.B; Kolawole I.K; Bolaji B.O.
    Introduction: The duration of action of sub-arachnoid block is short, and one of the ways to overcome this is the use of oral clonidine. Methods: 108 patients of ASA I and II, aged 18 to 65 years undergoing lower abdominal surgeries under spinal anaesthesia were randomized into three groups.. Control group A (n=36) no oral clonidine pre-medication, Group B (n=36) and group C (n=36) received 100 μg and 200 μg of oral clonidine pre-medication respectively, 1hr before spinal anaesthesia. Haemodynamic parameters were recorded. Sensory block, degree of motor blockage, and sedation were assessed. Results: Clonidine prolonged the mean duration of motor block by 189.98±26.93 min (100μg) and 191.89±28.13 min (200μg) compared to 117.92±25.13 min in the control group p<0.05. The mean duration of analgesia was 188.19±35 min (100μg) and194±24.58 min (200μg) in the clonidine groups compared to 115.89±26.66 min in control group p<0.05. All the patients were awake in the control group while 71.43% and 100% were drowsy in groups B and C respectively. Conclusion: Oral clonidine produces better clinical effects on the onset and duration of Bupivacaine spinal anaesthesia
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    Ondansetron versus Ephedrine for prophylaxis of subarachnoid Block-Induced Hypotension in Pregnant women.
    (Zambia Medical Association., 2025) Josiah .c; Bolaji B.O; Adegboye, M.B; Kolawole I.K
    Background: Hypotension is the most frequent adverse effect of subarachnoid block (SAB) in patients undergoing elective caesarean section (C/S), presenting a significant challenge to both maternal and foetal safety. It is believed that the Bezold-Jarisch reflex (BJR), triggered by serotoninmediated stimulation of 5-hydroxy-triptamine-3 (5- HT3) receptors in cardiac chambers, could be a contributor to the mechanism of SAB-induced hypotension. Therefore, the use of ondansetron, a 5- HT3 receptor antagonist, holds promise in mitigating this type of hypotension. Objective: The aim of this study was to compare the efficacy of prophylactic intravenous 4 mg ondansetron versus intravenous 15 mg ephedrine in reducing the incidence of SAB-induced hypotension in patients scheduled for elective caesarean section at the University of Ilorin Teaching Hospital. Methodology: This randomised controlled trial included 80 ASA 2 patients, between 18 and 40 years, who were scheduled for elective C/S under SAB. Participants were allocated to 2 groups of 40: Group OS received 4 mg intravenous ondansetron 10 minutes before SAB, and Group ES received 15 mg intravenous ephedrine immediately after SAB. The primary outcome measure was the incidence of hypotension while secondary outcome measures were quantity of phenylephrine and atropine consumption, incidence of post-spinal spinal shivering, and study drug side effects: hiccups, skin flushing, and headaches. Data Analysis: Statistical analysis was conducted using the Statistical Product and Service Solutions SPSS Statistic 20 (IBM Corp., Armonk, NY, USA), employing Chi-square test/ Fisher's exact test) or independent student's t-test as appropriate. P <0.05 was considered statistically significant. Results: The demographic characteristics and baseline haemodynamic parameters were similar across both groups. Although the incidence of hypotension recorded in the ephedrine group was 12.5% lower than that recorded in the ondansetron group, this was not statistically significant (60% in OS vs 47.5% in ES, 95% confidence interval [CI] = - 0.03 - 0.28, P = 0.37). Notably, the mean systolic blood pressure (SBP) was significantly higher in the ephedrine group (P< 0.05) at six critical time points. The mean DBP values were similar in both groups. Apart from the 4th minute, where the mean arterial blood pressure (MAP) value was significantly higher in the ephedrine group (82.73 ± 14.37 in ES vs 74.65 ± 15.17 in OS, 95% CI = -14.65 - -1.49, p = 0.02), the values were comparable at other times. The mean heart rate (HR) values were significantly elevated (P< 0.05) in the ephedrine group at nearly all-time intervals, barring the second minute. One patient in the ondansetron group experienced bradycardia, which was treated with 0.6 mg atropine, whereas none in the ephedrine had bradycardia. The mean consumption of phenylephrine (in μg) was lower in the ES group by 25 μg (77.50 ± 96.71 in group ES versus 102.50 ± 110.33 in group OS, 95% CI = -21.18 - 71.18, P = 0.28) but was not statistically significant. Interestingly, the percentage of participants in group OS who experienced shivering was 17.5% lower compared to the percentage in the ephedrine group (5% in group OS vs 22.5% in group ES, 95% CI = 0.03 - 0.32, P= 0.023). No significant differences in the incidences of study drug side effects were noted between the groups. Conclusion: Our findings suggest that prophylactic use of 4 mg intravenous ondansetron has a comparable efficacy to 15 mg intravenous ephedrine in preventing SAB-induced hypotension in pregnant women. However, patients pretreated with ondansetron before SAB had a significantly lower incidence of post-spinal shivering, indicating its potential value in enhancing maternal comfort and safety during caesarean sections.