British Journal of Anaesthesia, Vol 82, Issue 2 277-279, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
D. Ure, K. S. James, M. McNeill and J. V. Booth
We have tested the hypotheses that glycopyrrolate, administered immediately
before induction of subarachnoid anaesthesia for elective Caesarean
section, reduces the incidence and severity of nausea, with no adverse
effects on neonatal Apgar scores, in a double-blind, randomized, controlled
study. Fifty women received either glycopyrrolate 200 micrograms or saline
(placebo) i.v. during fluid preload, before induction of spinal anaesthesia
with 2.5 ml of 0.5% isobaric bupivacaine. Patients were questioned directly
regarding nausea at 3-min intervals throughout operation and asked to
report symptoms as they arose. The severity of nausea was assessed using a
verbal scoring system and was treated with increments of i.v. ephedrine and
fluids. Patients in the group pretreated with glycopyrrolate reported a
reduction in the frequency (P = 0.02) and severity (P = 0.03) of nausea.
Glycopyrrolate also reduced the severity of hypotension, as evidenced by
reduced ephedrine requirements (P = 0.02). There were no differences in
neonatal Apgar scores between groups.
SHORT COMMUNICATIONS
Glycopyrrolate reduces nausea during spinal anaesthesia for caesarean section without affecting neonatal outcome
Department of Anaesthesia, Glasgow Royal Infirmary, Castle Street, Glasgow G4 0SF, UK
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