European Journal of Molecular & Clinical Medicine

Abstract

Background: The physiological changes of pregnancy deem nausea and vomiting infallible complications associated with obstetric anaesthesia, resulting in significant morbidity and longer recovery time. The aim of our randomised control trial was to investigate the efficacy of propofol in addition to the currently accepted regimen of ranitidine and metoclopramide in the prevention of nausea and vomiting in this high risk group undergoing spinal anesthesia during caesarean section.
Methods: Eighty fasted term pregnant women scheduled for elective caesarean section were given ranitidine 150mg and metoclopramide 10mg orally 2 hours prior to spinal anaesthesia following which they received either propofol 200µg /kg IV or placebo as a single bolus dose. Intraoperative and post-delivery emetic episodes experienced were recorded at intervals and the intensity of nausea was assessed using the visual analogue scale (VAS).
Results: The incidence of nausea during the intraoperative period in propofol group was 5 % as compared with placebo group in which it was 32.5%, while that of vomiting in propofol group was 5% as compared with placebo group in which it was 22.5%. Both were found to be statistically significant (p= 0.002, p= 0.023 respectively). The incidence of nausea and vomiting during the entire postoperative period of 0-24 hours between the two groups was found to be statistically insignificant.
Conclusion: The prophylactic administration of a subhypnotic dose of propofol with ranitidine and metoclopramide was effective in the prevention of nausea and vomiting after neuraxial blockade during the intraoperative period but not during the postoperative period.