scholarly journals Effect of fentanyl on nausea and vomiting in cesarean section under spinal anesthesia: a randomized controlled study

2019 ◽  
Vol 47 (10) ◽  
pp. 4798-4807
Author(s):  
Dong Wook Shin ◽  
Yeojung Kim ◽  
Boohwi Hong ◽  
Seok-Hwa Yoon ◽  
Chae Seong Lim ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Patient Satisfaction Score ◽  
Sedation Level ◽  
Elective Cesarean ◽  
Group 5

Objective Although opioids may induce nausea and vomiting, they possess sedative effects and can reduce intraoperative nausea and vomiting (IONV). This study assessed the effect of adding fentanyl to midazolam on sedation levels and IONV during cesarean section under spinal anesthesia. Methods Eighty parturients scheduled for elective cesarean section were enrolled in the study. Following fetal delivery, patients were administered 0.05 mg/kg of midazolam plus 0.03 mL/kg of normal saline (M group) or 0.05 mg/kg of midazolam plus 1.5 μg/kg of fentanyl (MF group). The primary outcome was the incidence of IONV. The secondary outcomes were incidence of postoperative nausea and vomiting (PONV), intraoperative sedation level, and five-point patient satisfaction score (PSS). Results The IONV incidence was significantly lower in the MF group compared with the M group (5% [2/40] vs. 25% [10/40]). The PONV incidence did not differ significantly between the groups. The intraoperative sedation level tended to be deeper in the MF group. The 5-point PSS was significantly higher in the MF group. There was a strong correlation between the sedation level and IONV incidence. Conclusions Adding fentanyl to midazolam is effective for sedation and to prevent IONV in women who are undergoing cesarean section under spinal anesthesia.

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

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.

scholarly journals Hemodynamic effects of right pelvic wedge in patients undergoing elective cesarean section under spinal anesthesia

2018 ◽  
Vol 1 (2) ◽  
pp. 70-74
Author(s):  
Rohini Sigdel ◽  
Maya Lama ◽  
Sanish Gurung ◽  
Bishal Gurung ◽  
Anil Prasad Neupane ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Operating Table ◽  
Hemodynamic Effects ◽  
Elective Cesarean ◽  
Spinal Hypotension ◽  
The Right

Background: Several methods have been used to prevent post spinal hypotension including preloading, co-loading, use of vasopressors, placement of pelvic wedge, lumbar wedge and tilting of operating table in parturients undergoing cesarean section. We conducted a randomized controlled study to determine the hemodynamic effects of a standard pelvic wedge placed below the right hip immediately after the spinal block till the delivery of baby. Methods: One hundred consenting women undergoing elective cesarean section under spinal anesthesia were randomly allocated to wedge group (N=50) and control group (N=50). A standard wedge was placed under the right pelvis soon after spinal anesthesia till the delivery of baby in wedge group whereas the control group remained supine. Hemodynamic parameters including blood pressure, heart rate, vasopressor consumption, other side effects like nausea, vomiting and neonatal outcome were also recorded. Results: The incidence of hypotension and bradycardia was similar between groups (Wedge group 60% vs Control group 75.51%, p=0.125) before the birth of baby. The use of vasopressors (p=0.212), incidence of nausea (p=0.346) and Apgar score at 1 and 5 minutes (p=0.629, p=0.442) were also not statistically significant. None of the patients had vomiting. Conclusion: In our study, the use of right pelvic wedge immediately after spinal anesthesia was not effective in preventing post spinal hypotension in elective cesarean section.

Low Complication Rate Associated with Cesarean Section under Spinal Anesthesia for HIV-1–Infected Women on Antiretroviral Therapy

2002 ◽  
Vol 97 (2) ◽  
pp. 320-324 ◽  
Author(s):  
Michael S. Avidan ◽  
Philippa Groves ◽  
Margaret Blott ◽  
Jan Welch ◽  
Theresa Leung ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Postoperative Complications ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Elective Cesarean ◽  
Hiv 1

Background Elective cesarean section decreases the likelihood of vertical human immunodeficiency virus (HIV) transmission from mother to infant. This study aimed to determine whether cesarean section done with spinal anesthesia on HIV-1-infected pregnant women taking antiretroviral therapy is associated with intraoperative hemodynamic instability, postoperative complications, or changes in immune function or HIV-1 viral load. Methods A case-controlled study was conducted over a 3-year period in a London academic hospital. Forty-four women infected with HIV-1 and a control group of 45 HIV-negative women undergoing cesarean sections were included. The main outcome measures included intraoperative blood pressure, heart rate, blood loss, and ephedrine requirements, and postoperative infective complications, blood transfusion, changes in blood HIV-1 viral load and lymphocyte subsets, and time to hospital discharge. Results There were no differences in hemodynamic stability and postoperative complications between the HIV-infected group and the controls. There was an acute postoperative increase in the CD4T lymphocyte count (P = 0.01), but the CD4T:CD8T ratio and viral load did not change. Conclusions Elective cesarean section under spinal anesthesia for women infected with HIV-1 taking antiretroviral therapy was not associated with intraoperative or postoperative complications.

scholarly journals Efficacy of Intravenous Ondansetron on Hemodynamic Complications in Women Undergoing Spinal Anesthesia for Cesarean Section: A Randomized Placebo Controlled Clinical Trial

2016 ◽  
Vol 5 (1) ◽  
pp. 13-18
Author(s):  
Pouran Hajian ◽  
Bita Malekianzadeh ◽  
Maryam Davoudi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Controlled Clinical Trial ◽  
Sterile Water ◽  
Elective Cesarean

Background: Several methods are used for the prevention or decreasing the incidence of spinal anesthesia hemodynamic complications. Ondansetron is a 5HT3 receptor antagonist with known efficacy on preventing nausea and vomiting and probably on intrathecal opioid-induced pruritus. The present study aims to evaluate the effects of intravenous Ondansetron on the attenuation of blood pressure and heart rate, by 5HT3 blocking in vagal nerve endings and effect on Bezold Jarish reflex. Material and Methods: One hundred and two candidates for elective cesarean section were randomized into 2 groups of 51 cases, the Ondansetron group received 4mg Ondansetron intravenously before performing spinal anesthesia, and placebo group received 2cc sterile water. Hypotension was defined: Systolic blood pressure less than 100 MmHg or fall more than 20% from primary BP which was treated by administration of Ephedrine in case of any. In both groups, Ondansetron effect was studied on hypotension occurrence, bradycardia, consumed Ephedrine amount, pruritus, nausea and vomiting. Results: There were no statistically significant differences in systolic/diastolic blood pressure, Mean Arterial Pressure, heart rate and pruritus in both groups (P=0.081).Nausea and vomiting in the first 10 minutes after spinal anesthesia were lesser in Ondansetron group (P= 0.001). Mean consumed Ephedrine was significantly lesser in Ondansetron group (5.8 mg in Ondansetron and 10.7 mg in placebo group, P=0.009). Conclusion: Ondansetron  given  intravenously  with  antiemetic  dose  (4  mg)  decreases  mean consumed Ephedrine and nausea and vomiting after spinal anesthesia, but does not have an influence on blood pressure, heart rate and pruritus.[GMJ. 2016;5(1):13-18]

scholarly journals Low Dose Hyperbaric Bupivacaine with Fentanyl in Spinal Anesthesia in Elective Cesarean Section

2019 ◽  
Vol 9 (2) ◽  
pp. 79-82
Author(s):  
Bharati Devi Sharma Regmi ◽  
Gopendra Prasad Deo ◽  
Subin Shrestha ◽  
Sabita Shrestha ◽  
Renuka Tamrakar Mishra
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
Elective Cesarean

Background: Spinal anesthesia with hyperbaric bupivacaine provides a dense neural block in cesarean delivery but associated with side effects like hypotension, bradycardia nausea and vomiting. Addition of low dose fentanyl with low dose of hyperbaric bupivacaine may decrease the in­cidence of these complications. The aims of study was to compare the hemodynamic parameters (blood pressure and heart rate), nausea and vomiting with low dose intrathecal hyperbaric bupivacaine with fentanyl vs a conventional dose of intrathecal hyperbaric bupivacaine in patient undergoing elective cesarean section. Methods: Seventy-four pregnant women aged 20-35 years old which un­derwent elective cesarean section at Chitwan Medical College were ran­domized into two groups. One group received spinal anesthesia with 8mg of0.5% hyperbaric bupivacaine and 25μg fentanyl and another group re­ceived 12mg 0.5% bupivacaine. Results: The mean age, baseline heart rate, systolic and diastolic blood pressure were comparable in both groups. Significant difference in hypo­tension (24.31% vs. 62.16%, p<0.05) and Nausea and vomiting (16.20% vs. 27%, p<0.05) were found in bupivacaine-fentanyl group versus a conven­tional dose of spinal bupivacaine group. Conclusions: Low dose of bupivacaine with Fentanyl provides good spinal anesthesia for cesarean section with less hypotension, nausea and vomit­ing in comparison to bupivacaine alone.

scholarly journals Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study

2014 ◽  
Vol 29 (11) ◽  
pp. 752-758 ◽  
Author(s):  
Angélica de Fátima de Assunção Braga ◽  
Franklin Sarmento da Silva Braga ◽  
Eunice Sizue Hirata ◽  
Rosa Inês Costa Pereira ◽  
José Aristeu Frias ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Randomized Controlled Study ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Hyperbaric Bupivacaine ◽  
Randomized Controlled ◽  
Elective Cesarean

scholarly journals Comparison of the Prophylactic Effect of Propofol, Dexamethasone and Ondansetron on Post-Operative Nausea and Vomiting in Elective Cesarean Section Under Spinal Anesthesia

2021 ◽  
Author(s):  
Ebrahim Hassani ◽  
Nazli Karami ◽  
Asma Hassani ◽  
Leila Hassani ◽  
Veghar Ashraf
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Control Group ◽  
Double Blind ◽  
Short Period ◽  
Post Operative Nausea ◽  
Group D

Nausea, and vomiting are common complications in women undergoing cesarean section with spinal anesthesia. This study aimed to compare the propofol, dexamethasone, and ondansetron effects on nausea and vomiting. In this double-blind, randomized clinical trial study, 120 women aged 15 to 35 years candidates for cesarean section under spinal anesthesia were enrolled. Patients were randomly divided into four groups (three-drug groups and control group). Patients received 0.05 mg/kg ondansetron (group O), 0.1 mg/kg dexamethasone (group D), 0.2 mg/kg propofol (group P) and normal saline in controls (group C). Nausea and vomiting in recovery and 6 hours after surgery compared between groups. In recovery and 6 hours after surgery, both nausea and vomiting were the highest in group C while they were lowest in group O. the frequency of nausea was 11(36.7%) in both recovery and 6 hours after surgery, and the frequency of vomiting was 12(40%) and 10(33.3%) in the recovery and 6 hours after surgery respectively. Among three drug groups, nausea and vomiting were higher in group D in both the recovery room and 6 hours after surgery. The frequency of vomiting was 10 (33.3%) and 5 (16.7%) in recovery and 6 hours after surgery in group D, respectively. These differences were statistically significant between the four groups (P<0.05). The preventive effect of dexamethasone is not very useful in both periods. Therefore, it can be recommended that in the short period after surgery, propofol has a beneficial effect in preventing postoperative nausea and vomiting.

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