Comparison Between Cyclizine and Dexamethasone for Prevention of Nausea and Vomiting after Intrathecal Morphine in Patients Undergoing Cesarean Section

Document Type : Original Article

Authors

Department of Anesthesiology and Intensive Care; Assiut University Hospitals, Faculty of Medicine - Assiut University, Assiut, Egypt.

10.21608/jcmrp.2024.277047.1034

Abstract

Abstract:
 
Background: Postoperative nausea and vomiting (PONV) are frequent side effects of intrathecal morphine in patients undergoing cesarean section (CS). The prophylactic administration of combination antiemetic drugs is well established in modern anesthetic practice for the prevention of PONV in adult patients.
Methods: One hundred sixty uncomplicated term pregnant patients scheduled for elective cesarean section under spinal anesthesia were divided into two equal groups. The patients in both groups were given a subarachnoid block (2-3 mL hyperbaric bupivacaine plus 200 μg of morphine). After clamping the umbilical cord, 10 mg metoclopramide amp was added to the IV fluid in both groups. Then, the first group received 8 mg IV dexamethasone, and the second group received 50 mg IV cyclizine. The primary outcome was the number of patients who experienced PONV during the first postoperative 24 hours, and the second outcome was the side effects of the given drugs.
Results: The incidence of PONV was 25% in the dexamethasone group and 11% in the cyclizine group, with a significant difference between both groups (p < 0.05).
Conclusion: Combined with metoclopramide, cyclizine may be a good choice for prophylaxis against PONV in elective CS receiving intrathecal morphine.
 

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