Akpan Imeh1, Oladapo Olaniyi2, Olateju Simeon3, Odusoga Omotola4. 1. Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria; National Orthopaedic Hospital Igbobi, Lagos, Nigeria. 2. Lagos State School of Anaesthesia, Badagry, Nigeria. 3. Obafemi Awolowo University I le-Ife, Nigeria. 4. Olabisi Onabanjo University Teaching Hospital, Department of Obstetrics and Gynaecology, Sagamu, Nigeria.
Abstract
BACKGROUND:Intrathecal morphine for caesarean delivery provides excellent postoperative analgesia but it is commonly associated with nausea and vomiting. This prospective, randomized, double blind study was carried out to compare the effectiveness of a combination of dexamethasone and ondansetron with dexamethasone alone for prevention of postoperative nausea and vomiting (PONV) following intrathecal morphine injection for caesarean section. METHODS: A total of 108 parturients aged 18-40 years for elective caesarean section were randomized into 2 groups (n=54) to receive either intravenous dexamethasone 8 mg (Group A) or a combination of intravenous dexamethasone 8 mg and ondansetron 4 mg (group B). The study drug for each group consisted of 0.5% hyperbaric bupivacaine and 0.2mg morphine. The primary outcome variables were postoperative nausea and vomiting (PONV) which were assessed for a period of 24 hours. The patient's vital signs were monitored and documented. RESULTS: The incidence of nausea and vomiting was significantly reduced in patients who received a combination of dexamethasone and ondansetron compared with dexamethasone alone (9.3% Vs 37%, respectively, P = 0.003). CONCLUSION: This study showed that a combination of dexamethasone and ondansetron administered prophylactically significantly reduced the incidence of PONV in pregnant women on intrathecal morphine for caesarean section.
RCT Entities:
BACKGROUND: Intrathecal morphine for caesarean delivery provides excellent postoperative analgesia but it is commonly associated with nausea and vomiting. This prospective, randomized, double blind study was carried out to compare the effectiveness of a combination of dexamethasone and ondansetron with dexamethasone alone for prevention of postoperative nausea and vomiting (PONV) following intrathecal morphine injection for caesarean section. METHODS: A total of 108 parturients aged 18-40 years for elective caesarean section were randomized into 2 groups (n=54) to receive either intravenous dexamethasone 8 mg (Group A) or a combination of intravenous dexamethasone 8 mg and ondansetron 4 mg (group B). The study drug for each group consisted of 0.5% hyperbaric bupivacaine and 0.2mg morphine. The primary outcome variables were postoperative nausea and vomiting (PONV) which were assessed for a period of 24 hours. The patient's vital signs were monitored and documented. RESULTS: The incidence of nausea and vomiting was significantly reduced in patients who received a combination of dexamethasone and ondansetron compared with dexamethasone alone (9.3% Vs 37%, respectively, P = 0.003). CONCLUSION: This study showed that a combination of dexamethasone and ondansetron administered prophylactically significantly reduced the incidence of PONV in pregnant women on intrathecal morphine for caesarean section.
Entities:
Keywords:
Caesarean Section; Dexamethasone; Morphine; Nausea and Vomiting; Ondansetron
Authors: Szilvia Szarvas; Ramesh S Chellapuri; Dominic C Harmon; John Owens; Damian Murphy; George D Shorten Journal: Anesth Analg Date: 2003-07 Impact factor: 5.108
Authors: James D Griffiths; Gillian Ml Gyte; Phil A Popham; Kacey Williams; Shantini Paranjothy; Hannah K Broughton; Heather C Brown; Jane Thomas Journal: Cochrane Database Syst Rev Date: 2021-05-18