ArticleJournal of anesthesia2026
Effect of granisetron on the spinal anesthesia-induced hemodynamic changes: a meta-analysis of randomized controlled trials.
Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Authors and funding
3 authors.
Funding
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Abstract
backgroundSpinal anesthesia induces hemodynamic disturbances such as hypotension and bradycardia. Granisetron, a 5-HT₃ receptor antagonist primarily used for antiemesis, has been proposed to mitigate these effects.
methodsThis meta-analysis of randomized controlled trials evaluated intravenous granisetron versus placebo/no treatment in adults undergoing elective surgery under spinal anesthesia, reporting hypotension (primary outcome), bradycardia, shivering, hemodynamic changes, and vasopressor use. A random-effects model was used to calculate relative risks (RR) or mean differences (MD) with 95% confidence intervals (CI), with subgroup analysis by surgical type (cesarean vs. nonobstetric).
resultsFourteen trials (n = 1388) were included. Granisetron significantly reduced overall hypotension (RR = 0.51; p < 0.001), vasopressor use (RR = 0.64; p = 0.008), and shivering (RR = 0.32; p < 0.001). Bradycardia reduction was significant only in nonobstetric participants (RR = 0.48; p = 0.047), not overall (p = 0.118); similarly, mean arterial pressure (MAP) at 5 and 15 min (p = 0.001, p < 0.001) and heart rate at 5 min (p = 0.013) improved only in nonobstetric surgery, with no overall significance. Heterogeneity was substantial for most continuous outcomes (I
conclusionsGranisetron appears effective in reducing hypotension, vasopressor use, and shivering during spinal anesthesia, with early hemodynamic benefits in nonobstetric surgery. Given the heterogeneity and publication bias identified, findings warrant cautious interpretation requiring larger trials.
trial registrationPROSPERO, CRD420251034777. Registered 17 April 2025, https://www.crd.york.ac.uk/prospero/.
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