Prophylaxis Against Intraoperative Nausea And Vomiting During Spinal Anesthesia For Cesarean Section: A Comparative Study Of Ondansetron Versus Metoclopramide

Abstract

We intended to compare the preventive and therapeutic effects of ondansetron and metoclopramide, on the incidence of intraoperative nausea and vomiting (IONV) during cesarean section (C-section) under spinal anaesthesia. We performed a double-blind placebo-controlled study, including 150 ASA I-II women submitted to spinal anaesthesia for scheduled C-section. Four mg ondansetron (n=49), 10 mg metoclopramide (n=48) or saline (n=50), were administered i.v., depending on their treatment group. Whenever IONV appeared after we treated them with droperidol, if they had not subsided completely after five minutes. Nausea and vomiting occurred in 11.6% of the total cases. They were absent in 91.8% of the ondansetron group, 91.6% of the metoclopramide group and 60% of the placebo group (P<0.001 for both the ondansetron and the metoclopramide groups versus the placebo group, no significant difference between actively treated groups). Emetic symptoms were more frequent after clamping the umbilical cord (25,9%) than prior to it (16,3%) (P<0,05). Conclusion: This study showed a significantly lower incidence of IONV in the ondansetron and metoclopramide groups than in the placebo group, in women requiring a C-section under spinal anaesthesia. The ondansetron group was not statistically different from the metoclopramide group.