British Journal of Anaesthesia, 2003, Vol. 90, No. 5 665-670
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Clinical Investigations |
Prevention of postoperative nausea and vomiting after spinal morphine for Caesarean section: comparison of cyclizine, dexamethasone and placebo
1 University Department of Anaesthesia, Critical Care and Pain Management, Leicester University, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester LE5 4PW, UK. 2 The Mater Misericordiae Hospital, Dublin 7, Republic of Ireland
Corresponding author. E-mail: donal.buggy{at}nbsp.ie
Background. Low-dose intrathecal (spinal) morphine (0.1–0.2 mg) for Caesarean section delivers excellent postoperative analgesia but is associated with significant nausea and vomiting. We compared the antiemetic efficacy of cyclizine, dexamethasone, and placebo in this clinical setting.
Methods. Ninety-nine women undergoing elective Caesarean section under spinal anaesthesia were allocated randomly, in a double-blind study design, to receive either cyclizine 50 mg, dexamethasone 8 mg, or placebo as a single-dose infusion in saline 0.9%, 100 ml on completion of surgery. Spinal anaesthesia consisted of: hyperbaric bupivacaine 0.5%, 2.0 ml; fentanyl 10 µg; and spinal morphine 0.2 mg. The primary outcome measure was the incidence of nausea.
Results. The incidence of nausea was significantly less in patients receiving cyclizine compared with dexamethasone and placebo (33 vs 60 and 67%, respectively, P<0.05). Severity of nausea and number of vomiting episodes were also less at 3–6 h in cyclizine patients. Overall satisfaction with postoperative care at 24 h, expressed on a 100 mm visual analogue scale, was greater in cyclizine [78 (28)] than either dexamethasone [58 (31), P=0.03] or placebo [51 (28), P=0.008].
Conclusion. We conclude that following spinal morphine 0.2 mg and fentanyl 10 µg analgesia for Caesarean section, cyclizine 50 mg i.v. reduces the incidence of nausea compared with dexamethasone 8 mg i.v. or placebo. It also lessens the severity of nausea and vomiting, and increases maternal satisfaction in the early postoperative period.
Br J Anaesth 2003; 90: 665–70
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. K. Allen and A. S. Habib P6 Stimulation for the Prevention of Nausea and Vomiting Associated with Cesarean Delivery Under Neuraxial Anesthesia: A Systematic Review of Randomized Controlled Trials Anesth. Analg., October 1, 2008; 107(4): 1308 - 1312. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. P. Harnett, N. O'Rourke, M. Walsh, J. M. Carabuena, and S. Segal Transdermal Scopolamine for Prevention of Intrathecal Morphine-Induced Nausea and Vomiting After Cesarean Delivery Anesth. Analg., September 1, 2007; 105(3): 764 - 769. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Siddik-Sayyid, M. T. Aouad, S. K. Taha, M. S. Azar, M. A. Hakki, R. N. Kaddoum, V. G. Nasr, V. G. Yazbek, and A. S. Baraka Does Ondansetron or Granisetron Prevent Subarachnoid Morphine-Induced Pruritus After Cesarean Delivery? Anesth. Analg., February 1, 2007; 104(2): 421 - 424. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Habib, N. Itchon-Ramos, B. G. Phillips-Bute, T. J. Gan, and the Duke Women's Anesthesia (DWA) Research Group Transcutaneous Acupoint Electrical Stimulation with the ReliefBand(R) for the Prevention of Nausea and Vomiting During and After Cesarean Delivery Under Spinal Anesthesia Anesth. Analg., February 1, 2006; 102(2): 581 - 584. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Kinsella, N. A. Barrett, D. P. Dob, E. R. Ball, H. R. Jones, S. Saravanan, and G. Lyons Dose of intrathecal diamorphine for Caesarean section and position for spinal insertion Br. J. Anaesth., March 1, 2004; 92(3): 448 - 449. [Full Text] [PDF]
|
|