Transdermal Scopolamine Decreases Nausea and Vomiting Following Cesarean Section in Patients Receiving Epidural Morphine

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

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CONTROL OF POST-SURGICAL PAIN

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.03.2477 ◽

2010 ◽

Vol 17 (03) ◽

pp. 400-404

Author(s):

ALI MIR MANSOURI ◽

FARNOUSH FARZI ◽

SHIRIN KHALKHALIRAD ◽

Katayoon Haryalchi ◽

Abas Sediginejad

Keyword(s):

Pain Relief ◽

Cesarean Section ◽

Pain Control ◽

Nausea And Vomiting ◽

Chi Square ◽

Double Blind ◽

Analgesic Effects ◽

Emergency Cesarean ◽

Surgical Pain ◽

Chi Square Test

Introduction: There are many complications for patients with post cesarean section relative pain. So it delays in discharging or increasing in hospital stay. The objective of this study was a comparison between Tramadol and Meperidine according to pain relief or other possible complications in post cesarean section pain control. Materials and Methods: This study was a double blind clinical trial. It arranged for 240 parturients who scheduled for emergency cesarean section with pain after surgery in spite of spinal anesthesia. All patients were in ASA class I. They were divided randomly in two groups .Meperidine (M) and Tramadol (T) groups with 120 patients in each group. After beginning of pain in post anesthesia care unit (VAS> or = 4), in group (T) tramadol 1.5 mg/kg and in group (M) meperidine .5 mg/kg were injected intravenously. Apart from pain, other drug complications such as shivering, blood pressure changes, itching, nausea and vomiting, drowsiness were recorded one and two hours after injection. Data were analyzed by chi-square test. Results: Relative frequency rate (RFR) of 50% decrease in pain score one hour after intravenous injection was 56.7% in group (T) and 69.2% in group (M) ( P = 0.054). RFR for respiratory depression after one hour was 5.8% in (M) group and 0 in (T) group (P = 0.007). RFR for nausea after one hour was 39.2% in (T) group and 23.3% in (M) group (P = 0.008). RFR for vomiting after one hour was 23.3% in (T) group and 13.3% in (M) group (P= 0.045). RFR for drowsiness after one hour was 25% in (M) group and 3.3% in (T) group (P=0.007). There was no statistically significant relationship after 2nd hour for pain relief, nausea, vomiting and drowsiness between two groups. There was no difference between two groups in RFR for shivering, blood pressurechanges and itching in both two groups. Conclusion: This study illustrates both remedies Meperidine and Tramadol which were effective for pain relief and shivering after cesarean section. But according to high incidence of nausea and vomiting with Tramadol and more analgesic effects of Meperidine than Tramadol, administration of Meperidine is better than Tramadol after cesarean section for pain control.

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A Study of Effectiveness of Granisetron in Reducing the Incidence of Post Operative Nausea and Vomiting in Patients Undergoing Lower Segment Cesarean Section

Indian Journal of Anaesthesia and Analgesia ◽

10.21088/ijaa.2349.8471.4417.8 ◽

2017 ◽

Vol 4 (4 (Part-1)) ◽

pp. 964-968

Author(s):

Md. Ayathullah ◽

◽

Umapathy P ◽

Keyword(s):

Cesarean Section ◽

Nausea And Vomiting ◽

Lower Segment ◽

Lower Segment Cesarean Section ◽

Post Operative Nausea

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The Influence of Epidural Fentanyl and Meperidine injected during Cesarean Section on the Efficacy of Epidural Morphine

Korean Journal of Anesthesiology ◽

10.4097/kjae.1994.27.6.588 ◽

1994 ◽

Vol 27 (6) ◽

pp. 588

Author(s):

Yong Chul Kim ◽

Sung Soon Kim ◽

Seong Deok Kim

Keyword(s):

Cesarean Section ◽

Epidural Morphine ◽

Epidural Fentanyl

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Extraperitoneal versus transperitoneal cesarean section: a retrospective analysis

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200337 ◽

2020 ◽

Vol 9 (2) ◽

pp. 567

Author(s):

Babita P. Vaswani ◽

Aditi Trivedi ◽

Sriram Gopal

Keyword(s):

Cesarean Section ◽

Bowel Function ◽

Nausea And Vomiting ◽

Transperitoneal Approach ◽

Surgical Morbidity ◽

Post Operative Period ◽

Early Return ◽

Post Operative Pain ◽

Operative Recovery ◽

Delivery Type

Background: Cesarean section is becoming a more common delivery type worldwide. The objective of this study was to compare surgical morbidity in extraperitoneal versus transperitoneal techniques of cesarean section.Methods: A total of 60 patients was included in this study out of which 30 underwent extraperitoneal cesarean section(ECS) and 30 patients underwent transperitoneal cesarean section (TCS) and compared both the techniques with respect to nausea or vomiting intra-operatively, pain score (as measured by visual analogue scale) post operatively, return of bowel function and blood loss.Results: Intra-operative nausea and vomiting was noted in 33.34% of patients in TCS group while none of the patients in ECS group had any such complaints. No difference was noted in average blood loss between the 2 groups. Post-operative pain in ECS was 4.13 as compared to 6.86 in TCS. Return of bowel sounds in ECS group was much earlier (5.46 hours) as compared to TCS group (11.33 hours).Conclusions: We conclude that extraperitoneal technique is advantageous over transperitoneal approach. Decreased nausea and vomiting, early return of bowel function in the post-operative period, decreased post-operative pain allowing early feeding and mobilization are definite benefits of this technique. This further helps in making a relatively smoother post-operative recovery.

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