Reduction of emetic symptoms during cesarean delivery with antiemetics: propofol at subhypnotic dose versus traditional antiemetics.

Abstract

STUDY OBJECTIVE:

To evaluate the efficacy and safety of propofol (at a subhypnotic dose), droperidol, and metoclopramide in reducing emetic symptoms during cesarean delivery.

DESIGN:

Randomized, double-blinded, placebo-controlled study.

SETTING:

University hospital.

PATIENTS:

100 ASA physical status I and II parturients undergoing cesarean delivery with spinal anesthesia.

INTERVENTIONS:

Patients received placebo (saline) followed by placebo (Intralipid(R)), placebo (saline) followed by propofol at a subhypnotic dose (1.0 mg/kg/hr), droperidol 1.25 mg followed by placebo (Intralipid(R)), or metoclopramide 10 mg followed by placebo (Intralipid(R)) intravenously (IV) immediately after clamping of the umbilical cord.

MEASUREMENT AND MAIN RESULTS:

The percentage of patients who were emesis-free, which was defined as experiencing no nausea, retching, or vomiting, in the intraoperative, postdelivery period was 80% with propofol, 80% with droperidol, and 78% with metoclopramide (p < 0.05), compared with placebo (40%). Severity of nausea was less inpatients who received propofol than in those who received placebo (p < 0.05), and there were no differences seen among the droperidol, metoclopramide, and placebo groups. No clinically serious adverse events as a result of the study drugs were observed in any of the groups.

CONCLUSIONS:

Prophylactic antiemetic efficacy of propofol at a subhypnotic dose (1.0 mg/kg/hr), droperidol 1.25 mg, and metoclopramide 10 mg is comparable in parturients undergoing cesarean delivery. Moreover, propofol at a subhypnotic dose is effective in the prevention of severe nausea.

• Authors: Mitsuko Numazaki, Yoshitaka Fujii
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 15 Issue 6 Pg. 423-7 (Sep 2003) ISSN: 0952-8180 [Print] United States
• PMID: 14652118 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Retracted Publication)

Chemical References

• Antiemetics
• Metoclopramide
• Droperidol
• Propofol

Topics

• Adult
• Anesthesia, Obstetrical
• Anesthesia, Spinal
• Antiemetics (administration & dosage)
• Cesarean Section
• Double-Blind Method
• Droperidol (administration & dosage)
• Female
• Humans
• Metoclopramide (administration & dosage)
• Postoperative Nausea and Vomiting (prevention & control)
• Pregnancy
• Propofol (administration & dosage)