scholarly journals Prophylatic efficacy of dexamethasone, ketamine and dexmedetomidine against intra- and postoperative nausea and vomiting under spinal anesthesia

2019 ◽  
Vol 52 (1) ◽  
pp. 17
Author(s):  
Esmail Moshiri ◽  
Hesameddin Modir ◽  
Alireza Kamali ◽  
Maryam Shokrpour ◽  
Nilufar Shams
Keyword(s):  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting

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 Comparison of Postoperative Events between Spinal Anesthesia and General Anesthesia in Laparoscopic Cholecystectomy: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Xian-Xue Wang ◽  
Quan Zhou ◽  
Dao-Bo Pan ◽  
Hui-Wei Deng ◽  
Ai-Guo Zhou ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Confidence Interval ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Meta Analysis ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Urine Retention ◽  
Anesthesia Group

Background. Laparoscopic cholecystectomy is usually carried out under general anesthesia. There were a few studies which have found spinal anesthesia as a safe alternative. We aimed to evaluate the postoperative events between spinal anesthesia and general anesthesia in patients undergoing laparoscopic cholecystectomy.Methods. We searched PubMed, Embase, and Cochrane Library (from inception to January 2016) for eligible studies. The primary outcome was the visual analogue scale score. Secondary outcomes included postoperative nausea and vomiting and urine retention 24 hours postoperatively. We calculated pooled risk ratios and 95% confidence interval using random- or fixed-effects models.Results. Eight trials involving 723 patients were listed. Meta-analysis showed that patients in spinal anesthesia groups have lower visual analogue scale score 24 hours postoperatively. There were significant decreases in the occurrence of postoperative nausea and vomiting in spinal anesthesia group when compared with general anesthesia group (odds ratios: 0.38, 95% confidence interval: 0.19–0.76;P=0.006) with heterogeneity accepted (I2=13%;P=0.33), while urine retention rate was increased in patients with spinal anesthesia (odds ratios: 4.95, 95% confidence interval: 1.24–19.71;P=0.02) without any heterogeneity (I2=0%;P=0.98).Conclusions. Spinal anesthesia may be associated with less postoperative pain and postoperative nausea and vomiting compared with general anesthesia.

Addition of intrathecal atropine for prevention of postoperative nausea and vomiting in patients received intrathecal bupivacaine / morphine in lower limb surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim Abd Elghani Ramadan ◽  
Ashraf Elsayed Elagamy ◽  
Wael Sayed Ahmed Abd Elghaffar Elgharabawy ◽  
Ramez Mohamed Kamel Amin Elkady
Keyword(s):  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Lower Limb ◽  
Postoperative Nausea ◽  
Intrathecal Morphine ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Morphine Sulphate ◽  
Hyperbaric Bupivacaine ◽  
Preservative Free

Abstract Background Intrathecal opioids administration is an attractive analgesic technique since the opioids is injected directly into the cerebrospinal fluid providing safe and effective postoperative analgesia for up to 24 hours. The most common adverse effects after intrathecal morphine are postoperative nausea, vomiting and pruritus. We evaluated the effect of intrathecal atropine on prevention of postoperative nausea and vomiting in patients receiving intrathecal hyperbaric bupivacaine and morphine in lower limb surgeries and on its effect on duration of postoperative analgesia. Methods 80 patients undergoing lower limb surgeries under spinal anesthesia were randomized into two groups. BM group Received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 200 mcg of preservative-free morphine sulphate (0.2ml) + Normal saline (0.1ml). BMA group received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 200 mcg of preservative-free morphine sulphate (0.2ml) + 100 mcg preservative-free atropine sulphate (0.1ml). Follow-up of both nausea and vomiting episodes was done during the first 24 hours postoperatively. Results Nausea and vomiting were noticed in 17 patients (42.5%) in group BM and 7 patients (17.5%) in group BMA, with significant differences (p = 0.015). As regards postoperative analgesia, there was no significant differences between BM and BMA group. Conclusions Intrathecal atropine has antiemetic effect after spinal anesthesia using bupivacaine and morphine for lower limb surgeries without affecting postoperative analgesia.

scholarly journals Effect of single-dose intravenous dexamethasone on postoperative pain and postoperative nausea and vomiting in patients undergoing lower segment cesarean section under spinal anesthesia

2022 ◽  
Vol 13 (1) ◽  
pp. 31-37
Author(s):  
Nazima Memon ◽  
Juhi Bagga
Keyword(s):  
Single Dose ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Lower Segment ◽  
Hemodynamic Stability ◽  
Post Operative Pain ◽  
Group D

Background: Lower segment caesarean sections (LSCS) are commonly done under spinal anaesthesia. Although spinal anaesthetic techniques are relatively safe and associated with quick and uneventful recovery, post-operative pain is a major concern after effect of spinal anaesthesia weans off. Other than pain postoperative nausea and vomiting (PONV) is one of the important side effects of spinal anaesthesia. Steroids by virtue of their anti-inflammatory effect is expected to reduce pain consequent upon inflammation and many studies have shown their efficacy in reducing pain as well as PONV in post-operative patients. Aims and Objectives: Primary objective of the study was to evaluate efficacy of single-dose dexamethasone in reducing post-operative pain. The secondary objectives were to analyse effect of single-dose dexamethasone on hemodynamic stability as well as incidence of nausea and vomiting in patients undergoing LSCS under spinal anesthesia. Materials and Methods: This was a double-blind comparative study in which 60 patients undergoing LSCS under spinal anaesthesia were included on the basis of a predefined inclusion and exclusion criteria. Written informed consent was obtained from all patients. The patients were divided into two groups: Group D: 30 patients who received IV dexamethasone 8 mg (2 ml) intravenously just before giving spinal anesthesia. Group N: 30 patients who received Normal saline (2 ml) immediately before spinal anesthesia. In both groups, hemodynamic parameters, respiratory rate, severity of post-operative pain, and incidence of PONV was compared. P value less than 0.05 was taken as statistically significant. Results: Patients in Group D had significantly less severe post-operative pain (as assessed by the Visual analog scale) and incidence of PONV (P<0.05). Significantly less post-operative rescue analgesia was required in patients who received single dose of intravenous dexamethasone (P<0.05). In terms of hemodynamic stability, both groups were found to be comparable with no statistically significant difference. Conclusion: Single-dose dexamethasone is effective in reducing post-operative pain as well as incidence of PONV in patients undergoing LSCS under spinal anesthesia.

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