Abstract
Objective: To study the efficacy of ginger on the Nausea and Vomiting during and after Cesarean Section under Spinal Anesthesia. Study Design: Double blind randomized controlled trial. Setting: Department of Obstetrics and Gynecology, Ahvaz University, Razi Hospital. Material and Method: From January 2008 to April 2008, 70 pregnant women underwent for elective cesarean section under spinal anesthesia were randomized received coded drug one hour prior section with 30 ml water. The patients were at term, single pregnancy, uterine and abdominal incision transversal, and spinal anesthesia with lidocain 5%. Patients were matched in two groups by these factors: age, height, weight, BMI, cause of cesarean section, gestational age, hypotention during and after cesarean section, duration of operation and nausea and vomiting in pregnancy. All patients were assessed for severity of nausea by visual analog nausea score (VANS). Frequency of vomiting and need antiemetic drug were evaluated during and 0/5, 1, 2, 4, 6 hours after cesarean section. Results: The results demonstrated the statistically significant differences in severity of nausea and vomiting during cesarean section (p = 0/000). Severity of nausea (p = 0/000) and vomiting (0/046) after cesarean section also was lower in ginger group than placebo group. There were statistically significant differences between two groups for need antiemetic drug during (0/000) and after (0/003) cesarean section. This need was lower in ginger group than placebo group. Side effects caused by ginger were not detected. Conclusion: Ginger has efficacy in decrease severity of nausea and vomiting during and after cesarean section under spinal anesthesia.
Highlights
More than 23 million surgical procedures are performed annually [1]
Pregnant women undergoing spinal anesthesia are more prone to nausea and vomiting during surgery due to orthostatic hypotension and progesterone-dependent relaxation of smooth muscles and decreased gastrointestinal motility and esophageal sphincter tone [9]
Seven women (20%) in the trial group and 22 women (62.9%) in the control group vomited during surgery and the Chi-square test reported a significant difference between the two groups in this regard (p = 0.0001)
Summary
More than 23 million surgical procedures are performed annually [1]. As a major surgical procedure, caesarean section is the most common surgery in most hospitals in the Unites States [2], where it has quadrupled in the last two decades [3]. Spinal anesthesia is the most common anesthesia method for elective cesarean section [6], but it has some complications such as decreased blood pressure, spinal headaches, itching, nausea and vomiting. The latter complication occurs in 46% - 80% of cesarean section under spinal anesthesia [7]. In the United States, the average treatment cost for a patient experiencing nausea and vomiting after cesarean section is 14.94 dollars including personnel wages, supplements, medications, increased hospital stay in post-op care unit, and amounts to about 253,000 - 520,000 dollars in a fiscal year [11]. Ginger root is a common old spice, recognized as a dietary supplement by the Food and Drug Administration (FDA) [21] and without any complications or interaction with other medications as mentioned in Commission E monograph [22]
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