Could Emesis from Epidural Anesthesia for a Cesarean Section be Controlled by Prophylactic Low-Dose Granisetron?.
10.4097/kjae.2002.43.6.s13
- Author:
Youn Woo LEE
1
;
Jeong Yeon HONG
;
Hea Jo YOON
;
Soo Mie KIM
Author Information
1. Department of Anesthesiology, Yongdong Severance Hospital, Yonsei University College of Medicine, Korae.
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Antiemetics;
cesarean section;
epidural anesthesia;
granisetron;
nausea;
vomiting
- MeSH:
Anesthesia, Conduction;
Anesthesia, Epidural*;
Antiemetics;
Cesarean Section*;
Dizziness;
Ephedrine;
Epinephrine;
Female;
Granisetron*;
Headache;
Humans;
Hypotension;
Lidocaine;
Morphine;
Nausea;
Pain, Postoperative;
Postoperative Nausea and Vomiting;
Pregnancy;
Prospective Studies;
Pruritus;
Vomiting*
- From:Korean Journal of Anesthesiology
2002;43(6):s13-s19
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Nausea and vomiting during regional anesthesia for a cesarean section are common and unpleasant complications. This study was designed to assess the efficacy of prophylactic low dose granisetron on nausea and vomiting of patients undergoing a cesarean section with epidural anesthesia in a prospective, randomized, and double blind manner. METHODS: Sixty obstetric patients not in labor received epidural anesthesia with 20 mL of 2% lidocaine plus epinephrine (1 : 100,000) and 4 mL of diluted morphine 2 mg was administrated for postoperative pain control. Maternal hypotension was prevented aggressively by fluid administration and an ephedrine injection. The patients were assigned randomly to one of four groups to receive a placebo (normal saline) or granisetron in a dose of 10micro gram/kg, 20micro gram/kg, or 30micro gram/kg i.v. before peritoneal closure. Emetic episodes and emetic scores rating from 0 to 4 were observed during the 24 hours after surgery. RESULTS: The emetic score was statistically lower in the granisetron 30micro gram/kg group than the other groups, and was lower in the granisetron 20micro gram/kg group than the placebo and granisetron 10micro gram/kg group. Adverse events were headache, dizziness, sedation and pruritus, which were not serious. CONCLUSIONS: Prophylactic use of low dose granisetron (20-30micro gram/kg) is effective in postoperative nausea and vomiting in a cesarean section with epidural anesthesia using lidocaine and morphine when hypotension as one of the contributing factors was minimized.
