A RANDOMIZED COMPARISON OF DIMENHYDRINATE, METOCLOPRAMIDE AND PLACEBO FOR THE PREVENTION OF NAUSEA AND VOMITING FOLLOWING INTRATHECAL FENTANYL AND MORPHINE IN CESAREAN DELIVERY

作者：Duman Ates^*; Apiliogullari Seza; Gok Funda; Sutcu Erdinc; Soysal Sema; Toy Harun

来源：Nobel Medicus, 2010, 6(3): 13-19.

• Cesarean section
• dimenhydrinate
• fentanyl
• metoclopramide morphine

Objective Intrathecal morphine for cesarean section provides excellent postoperative analgesia however is associated with significant nausea and vomiting This study was designed to compare the effectiveness of prophylactic use of dimenhydrinate and metoclopramide to placebo for the prevention of nausea and vomiting following intrathecal fentanyl and morphine used for cesarean section
Material and Method Two hundred ten patents undergoing cesarean section under spinal anesthesia were included in this double blind and randomized study Spinal anesthesia was performed with 10 mg of hyperbaric bupivacaine combined with 20 mu g fentanyl and 200 mu g morphine After clamping the umbilical cord patients were randomly allocated to receive 50 mg dimenhydrinate intravenously (Group D) 10 mg metoclopramide (Group M) or 0 9% NaCl as placebo (Group P) The incidence of postoperative nausea or vomiting (PONV) during the first 24 postoperative hours was evaluated
Results The postoperative incidence of PONV was significantly lower in Group D (11%) than in Group M (28%) and Group P (32%) (p=0 02) The incidence and severity of postoperative nausea were significantly lower with the use of dimenhydrinate as compared to metoclopramide and placebo group (p= 0 01)
Conclusion The prophylactic use of dimenhydrinate (50 mg intravenously) as compared either to metoclopramide (10 mg) or placebo effectively decreased the incidence of PONV following intrathecal fentanyl and morphine for cesarean section

• 出版日期2010-12