Korean J Anesthesiol.  2002 Dec;43(6):s13-s19. 10.4097/kjae.2002.43.6.s13.

Could Emesis from Epidural Anesthesia for a Cesarean Section be Controlled by Prophylactic Low-Dose Granisetron?

• Lee YW
• Hong JY
• Yoon HJ
• Kim SM

• KMID: 1860648
• DOI: http://doi.org/10.4097/kjae.2002.43.6.s13

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.

Keyword

Antiemetics; cesarean section; epidural anesthesia; granisetron; nausea; vomiting

MeSH Terms

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*
Antiemetics
Ephedrine
Epinephrine
Granisetron
Lidocaine
Morphine