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Apr 2019, Vol 7, Issue 2
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Original Article
The Effect of Adding Ondansetroneon to Metoclopramide –Phenylephrine Combination in Prevention of Nausea and Vomiting During Spinal Anesthesia for Cesarean Section
Sousan Rasooli1, Farnaz Moslemi1, Gogazadeh M2
1Department of Anesthesiology, Tabriz University of Medical Science,Tabriz ,Iran
2Department of Anesthesiology, Tabriz University of Medical Sciences,Tabriz ,Iran

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Keywords : Metoclopramide, Ondansetroneon, Nausea- vomiting, Cesarean section, Spinal anesthesia
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Objectives: In the present study, therapeutic and preventive effects of Ondansetrone and Metoclopramide –Phenylephrine combination on the occurrence and severity of intraoperative nausea and vomiting throughout elective cesarean section under spinal anesthesia were evaluated.

Materials and Methods: In a randomized, double blind and placebo-controlled clinical trial, 110 ASA class I and II parturients, aged 20-30 years, undergoing spinal anesthesia for cesarean section were randomly allocated to one of two groups receiving Metoclopramide (10 mg IV before spinal anesthesia , n=55), Metoclopramide and Ondansetroneon (10 mg bolus before spinal anesthesia and 4.0 mg after umbilical cord clamping, n=55) and immediately after spinal anesthesia, prophylactic Phenylephrine infusion initiated. Bupivacaine hydrochloride (10 mg) and Fentanyl 10 µg was used for induction of the anesthesia. Patients’ hemodynamic was monitored at 3 minutes intervals. Intra-operative and post-delivery emetic episodes, severity of emesis, sedation score and ephedrine consumption were recorded.

Results: There was not any significant difference in demographic data (p>0/05).Incidence and severity of nausea and vomiting were significantly lower in Metoclopramide and Ondansetrone group than Metoclopramide group (p=0.033 and p=0.03 respectively) .Regarding to phenylephrine infusion in both groups, there were no significant difference in blood pressure, heart rate and ephedrine consumption between two group. Also the incidence of other complications like shivering and pruritis were similar in both groups.

Conclusion: Combination therapy with Metoclopramide and Ondansetrone along with prophylaxis of hypotension with Phenylephrine can significantly reduce intra and postoperative nausea and vomiting and its severity in patients undergoing cesarean section with spinal anesthesia.

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