Prophylactic multimodal antiemetic in women undergoing cesarean section under spinal anesthesia

Background: To find out the cost effective antiemetic drug combination as a prophylaxis against nausea and vomiting during regional anesthesia for cesarean section. Methods: After the gaining of institutional ethical approval, 240 parturients scheduled for elective cesarean delivery under spinal anesthesia were randomly allocated to receive either 2 mg granisetron plus 8 mg dexamethasone (group II) IV immediately after clamping of the fetal umbilical cord or 2 mg midazolam plus 8 mg dexamethasone (group III) IV or placebo (group I). Results: The use of rescue antiemetic medication, which indicates either vomiting or severe nausea, in the post delivery period intraoperatively was 37%, 14%, 23% in group I, II and III, respectively. These values are significantly less than the corresponding values during the first 24 h after surgery which was 20%, 7%, 13%, respectively. No clinically serious adverse events were observed in any of the groups. Conclusion: The prophylactic use of a granisetron/dexamethasone combination is better than midazolam/dexamethasone for reducing nausea and vomiting in patients during and after spinal anesthesia for cesarean section. (C) 2011 Egyptian Society of Anesthesiologists. Production and hosting by Elsevier B.V.