Y Fujii1, H Tanaka, H Toyooka. 1. Department of Anaesthesiology, Toride Kyodo General Hospital, Ibaraki, Japan.
Abstract
BACKGROUND:Nausea and vomitingduring and after spinal anaesthesia for caesarean section are distressing to the patient. This study was undertaken to evaluate the efficacy and safety of granisetron, droperidol and metoclopramide for the prevention of nausea and vomiting in parturients undergoing caesarean section under spinal anaesthesia. METHODS: In a randomized, double-blind, placebo-controlled trial, 120 patients receivedgranisetron 3 mg, droperidol 1.25 mg, metoclopramide 10 mg or placebo (saline) (n = 30 of each) i.v. immediately after clamping of the foetal umbilical cord. Nausea, vomiting and safety assessments were performed during and after spinal anaesthesia for caesarean section. RESULTS: The incidence of intraoperative, post-delivery nausea and vomiting was 13%, 17%, 20% and 63% after administration of granisetron, droperidol, metoclopramide and placebo, respectively; the corresponding incidence during 0-3 h after surgery was 7%, 27%, 27% and 43%; the corresponding incidence during 3-24 h after surgery was 7%, 20%, 23% and 37% (P < 0.05; overall Fisher's exact probability test). No clinically important adverse events were observed in any of the groups. CONCLUSION:Granisetron is highly effective for preventing nausea and vomitingduring and after spinal anaesthesia for caesarean section. Droperidol and metoclopramide are effective for the prevention of intraoperative, post-delivery emesis, but are ineffective for the reduction of the incidence of postoperative emesis.
RCT Entities:
BACKGROUND:Nausea and vomiting during and after spinal anaesthesia for caesarean section are distressing to the patient. This study was undertaken to evaluate the efficacy and safety of granisetron, droperidol and metoclopramide for the prevention of nausea and vomiting in parturients undergoing caesarean section under spinal anaesthesia. METHODS: In a randomized, double-blind, placebo-controlled trial, 120 patients received granisetron 3 mg, droperidol 1.25 mg, metoclopramide 10 mg or placebo (saline) (n = 30 of each) i.v. immediately after clamping of the foetal umbilical cord. Nausea, vomiting and safety assessments were performed during and after spinal anaesthesia for caesarean section. RESULTS: The incidence of intraoperative, post-delivery nausea and vomiting was 13%, 17%, 20% and 63% after administration of granisetron, droperidol, metoclopramide and placebo, respectively; the corresponding incidence during 0-3 h after surgery was 7%, 27%, 27% and 43%; the corresponding incidence during 3-24 h after surgery was 7%, 20%, 23% and 37% (P < 0.05; overall Fisher's exact probability test). No clinically important adverse events were observed in any of the groups. CONCLUSION:Granisetron is highly effective for preventing nausea and vomiting during and after spinal anaesthesia for caesarean section. Droperidol and metoclopramide are effective for the prevention of intraoperative, post-delivery emesis, but are ineffective for the reduction of the incidence of postoperative emesis.
Authors: Shantini Paranjothy; James D Griffiths; Hannah K Broughton; Gillian Ml Gyte; Heather C Brown; Jane Thomas Journal: Cochrane Database Syst Rev Date: 2010-01-20
Authors: James D Griffiths; Gillian M L Gyte; Shantini Paranjothy; Heather C Brown; Hannah K Broughton; Jane Thomas Journal: Cochrane Database Syst Rev Date: 2012-09-12
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