Comparison of incidents of nausea and vomiting between general anesthesia With Endotracheal tube and spinal anesthesia in cesarean sections
Main Article Content
Keywords
Nausea, Vomiting, General Anesthesia, Spinal Anesthesia, Cesarean Sections
Abstract
Introduction: Nausea refers to a sense of vomiting inclination, while Vomiting refers to reflux of the gastric contents, it is multidimensional phenomena influenced by a variety of risk factors began during the operation and persisted in the recovery period. Postoperative phase results in decreased patient comfort, an extended stay in the PACU.
Aim: To determine and compare which type of anesthesia leading to higher incidence of nausea and vomiting.
Patients & Methods: (110) patients of 18-40 years with ASA I and II were assigned according to the type of anesthesia that will be used. The two groups of study (general and spinal anesthesia) each group contain 55 participants. Within the groups 28 of parturient received metoclopramide while the other 27 women were received ondansetron. Measuring times of episodes of intra-postoperative NV, time of recovery, hemodynamic parameters before and after incidents of NV, times of drug administration. Data analysis done by SPSS version 24.
Results: times of episodes of NV was significantly less in spinal anesthesia group compared to general group (p<0.05) moreover, significant decrease of systolic and diastolic BP before and after intra - postoperative NV was obvious in spinal anesthesia group, in addition times of drug administration with metoclopramide in spinal group was high significantly(p<0.05).
Conclusion: spinal anesthesia technique achieved better result in the term of reducing the incidence ofNV, Moreover 4mg I.V of ondansetron significantly related to decrease in IONV, PONV rather than 10 mg of metoclopramide
References
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vs. balanced anesthesia. Korean Journal of Anesthesiology. 2011;60(6):416–21.
26. Simeneh Endalew EN, Gebremedhn EG, Gebreegzi AH, Gebreegzi AH, Kassahun HG, Kassa AA, et al. Effectiveness of Intravenous
Metoclopramide Prophylaxis on the Reduction of Intraoperative and Early Postoperative Nausea and
Vomiting after Emergency Caesarean Section under Spinal Anaesthesia. J Anesth Clin Res [Internet]. 2018 [cited 2023 Jan 14];09(03). Available from: https://www.omicsonline.org/openaccess/effectiveness-of-intravenousmetoclopramide-prophylaxis-on-the-reduction-ofintraoperative-and-early-postoperative-nausea-andvomi-2155-6148-1000809-99982.html
27. Ashagrie HE, Filatie TD, Melesse DY, Mustefa S. The incidence and factors associated with intraoperative nausea and vomiting during
cesarean section under spinal anesthesia, July 2019. An institution based cross sectional study. International Journal of Surgery Open.
2020;26:49–54.
28. Apfel CC, Turan A, Pocock SJ, Roewer N. A Factorial Trial of Six Interventions for the Prevention of Postoperative Nausea and Vomiting. The New England Journal of Medicine. 2004;11.
29. Carlisle J, Stevenson CA. Drugs for preventing postoperative nausea and vomiting. Cochrane database of systematic reviews. 2006;(3).
30. Christofaki M, Papaioannou A. Ondansetron: a review of pharmacokinetics and clinical experience in postoperative nausea and vomiting. Expert Opinion on Drug Metabolism & Toxicology. 2014 Mar;10(3):437–44.
31. Kaki A. Prophylaxis of postoperative nausea and vomiting with ondansetron, metoclopramide, or placebo in total intravenous anesthesia patients undergoing laparoscopic cholecystectomy. Saudi Med J. 2008;29(10).
32. Sandhu T, Tanvatcharaphan P, Cheunjongkolkul V. Ondansetron versus metoclopramide in prophylaxis of nausea and vomiting for
laparoscopic cholecystectomy: a prospective double-blind randomized study. Asian journal of surgery. 2008;31(2):50–4.
33. Nakatani H, Naito Y, Ida M, Sato M, Okamoto N, Nishiwada T, et al. Association between intraoperative hypotension and postoperative nausea and vomiting: a retrospective analysis of 247 thyroidectomy cases. Brazilian Journal of
Anesthesiology (English Edition). 2021 Mar;S0104001421000944.
34. Eberhart L, Seeling W, Ulrich B, Morin A, Georgieff M. Dimenhydrinate and metoclopramide alone or in combination for prophylaxis of PONV. Canadian Journal of Anesthesia. 2000;47:780–5.
35. Quaynor H, Raeder J. Incidence and severity of postoperative nausea and vomiting are similar after metoclopramide 20 mg and ondansetron 8 mg given by the end of laparoscopic cholecystectomies. Acta anaesthesiologica scandinavica. 2002;46(1):109–13.
36. Wallenborn J, Gelbrich G, Bulst D, Behrends K, Wallenborn H, Rohrbach A, et al. Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone: randomised double blind multicentre trial. BMJ. 2006 Aug 12;333(7563):324.
37. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
38. Gulati, H. ., & Rana, S. . (2022). Habitat Preference and Current Threats to The Sarus Cranes Grus Antigone (Aves: Gruiformes:
Gruidae) In Important Bird Areas of Haryana, India: Implications for Determining Effective Conservation Actions. Journal Of Advanced Zoology, 43(1), 07–16. Retrieved from http://jazindia.com/index.php/jaz/article/view/110
39. Mokhtar, A. R. R. A. S. . (2022). Development Of Saponin Based Wettable Powder Formulation from Phaleria macrocarpa To Control Pomacea maculate. Journal Of Advanced Zoology, 43(1), 17–31. Retrieved from http://jazindia.com/index.php/jaz/article/view/111
2. Sizemore DC, Singh A, Dua A, Singh K, Grose BW. Postoperative nausea. In: StatPearls [Internet]. StatPearls Publishing; 2022.
3. Elvir-Lazo OL, White PF, Yumul R, Eng HC. Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Research. 2020;9.
4. Amirshahi M, Behnamfar N, Badakhsh M, Rafiemanesh H, Keikhaie K, Sheyback M, et al. Prevalence of postoperative nausea and vomiting:A systematic review and meta-analysis. Saudi J Anaesth. 2020;14(1):48.
5. Moon YE. Postoperative nausea and vomiting. Korean J Anesthesiol. 2014;67(3):164.
6. Voigt M, Fröhlich CW, Hüttel C, Kranke P, Mennen J, Boessneck O, et al. Prophylaxis of intra- and postoperative nausea and vomiting in patients during cesarean section in spinal anesthesia. Med Sci Monit. 2013 Nov 14;19:993–1000.
7. Brodsky JB, Lemmens HJM. Regional anesthesia and obesity. OBES SURG. 2007 Sep;17(9):1146–9.
8. Devroe S, Van de Velde M, Rex S. General anesthesia for caesarean section. Current Opinion in Anaesthesiology. 2015 Jun;28(3):240–6.
9. Šklebar I. Spinal Anaesthesia-induced Hypotension in Obstetrics: Prevention and Therapy. ACC [Internet]. 2019 [cited 2023 Feb
23]; Available from: https://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=327123
10. Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, et al. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Pregnancy and Childbirth Group, editor. Cochrane Database of Systematic Reviews [Internet]. 2017 Aug 4 [cited 2023 Feb 23]; Available from: https://doi.wiley.com/10.1002/14651858.CD002251.pub3
11. Ngan Kee WD, Lee A, Khaw KS, Ng FF, Karmakar MK, Gin T. A Randomized DoubleBlinded Comparison of Phenylephrine and Ephedrine Infusion Combinations to Maintain Blood Pressure During Spinal Anesthesia for Cesarean Delivery: The Effects on Fetal Acid-Base Status and Hemodynamic Control. Anesthesia & Analgesia. 2008 Oct;107(4):1295–302.
12. Kinsella S, Carvalho B, Dyer R, Fernando R, McDonnell N, Mercier F, et al. International consensus statement on the management of
hypotension with vasopressors during caesarean section under spinal anaesthesia. Obstetric Anesthesia Digest. 2018;38(4):171–2.
13. Langesæter E, Dyer RA. Maternal haemodynamic changes during spinal anaesthesia for caesarean section. Current Opinion in Anaesthesiology. 2011 Jun;24(3):242–8.
14. Fitzgerald JP, Fedoruk KA, Jadin SM, Carvalho B, Halpern SH. Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials. Anaesthesia. 2020 Jan;75(1):109–
21.
15. Salinas FV, Sueda LA, Liu SS. Physiology of spinal anaesthesia and practical suggestions for successful spinal anaesthesia. Best Practice & Research Clinical Anaesthesiology. 2003;17(3):289–303.
16. Borgeat A, Ekatodramis G, Schenker CA. Postoperative Nausea and Vomiting in Regional Anesthesia. Anesthesiology. 2003 Feb
1;98(2):530–47.
17. Rasooli S, Moslemi F, Gogazadeh M. Preventing Nausea and Vomiting Using Ondansetron and Metoclopramide-Phenylephrine in Cesarean Section Using Spinal Anesthesia. 2019;6(1).
18. Chinachoti T, Tritrakarn T. Prospective Study of Hypotension and Bradycardia during Spinal Anesthesia with Bupivacaine: Incidence and Risk Factors, Part Two. 2007;90(3).
19. Jadon A. Complications of regional and general anaesthesia in obstetric practice. Indian J Anaesth. 2010;54(5):415.
20. Neal JM. Hypotension and bradycardia during spinal anesthesia: Significance, prevention, and treatment. Techniques in Regional Anesthesia and Pain Management. 2000 Oct;4(4):148–54.
21. Obi V, Umeora OJ. Anesthesia for emergency cesarean section: A comparison of spinal versus general anesthesia on maternal and neonatal outcomes. African Journal of Medical and Health Sciences. 2018;17(1):31–31.
22. Sener EB, Guldogus F, Karakaya D, Barıs S, Kocamanoglu S, Tur A. Comparison of Neonatal Effects of Epidural and General Anesthesia for Cesarean Section. Gynecol Obstet Invest. 2003;55(1):41–5.
23. Amiri AA, Karvandian K, Ashouri M, Rahimi M, Amiri AA. Comparison of post-operative nausea and vomiting with intravenous versus inhalational anesthesia in laparotomic abdominal surgery: a randomized clinical trial. Brazilian Journal of Anesthesiology (English Edition). 2020 Sep;70(5):471–6.
24. Röhm K, Piper S, Suttner S, Schuler S, Boldt J. Early recovery, cognitive function and costs of a desflurane inhalational vs. a total intravenous anaesthesia regimen in long-term surgery. Acta anaesthesiologica scandinavica. 2006;50(1):14–8.25. Kim GH, Ahn HJ, Kim HS, Bang SR, Cho HS, Yang M, et al. Postoperative nausea and vomiting after endoscopic thyroidectomy: total intravenous
vs. balanced anesthesia. Korean Journal of Anesthesiology. 2011;60(6):416–21.
26. Simeneh Endalew EN, Gebremedhn EG, Gebreegzi AH, Gebreegzi AH, Kassahun HG, Kassa AA, et al. Effectiveness of Intravenous
Metoclopramide Prophylaxis on the Reduction of Intraoperative and Early Postoperative Nausea and
Vomiting after Emergency Caesarean Section under Spinal Anaesthesia. J Anesth Clin Res [Internet]. 2018 [cited 2023 Jan 14];09(03). Available from: https://www.omicsonline.org/openaccess/effectiveness-of-intravenousmetoclopramide-prophylaxis-on-the-reduction-ofintraoperative-and-early-postoperative-nausea-andvomi-2155-6148-1000809-99982.html
27. Ashagrie HE, Filatie TD, Melesse DY, Mustefa S. The incidence and factors associated with intraoperative nausea and vomiting during
cesarean section under spinal anesthesia, July 2019. An institution based cross sectional study. International Journal of Surgery Open.
2020;26:49–54.
28. Apfel CC, Turan A, Pocock SJ, Roewer N. A Factorial Trial of Six Interventions for the Prevention of Postoperative Nausea and Vomiting. The New England Journal of Medicine. 2004;11.
29. Carlisle J, Stevenson CA. Drugs for preventing postoperative nausea and vomiting. Cochrane database of systematic reviews. 2006;(3).
30. Christofaki M, Papaioannou A. Ondansetron: a review of pharmacokinetics and clinical experience in postoperative nausea and vomiting. Expert Opinion on Drug Metabolism & Toxicology. 2014 Mar;10(3):437–44.
31. Kaki A. Prophylaxis of postoperative nausea and vomiting with ondansetron, metoclopramide, or placebo in total intravenous anesthesia patients undergoing laparoscopic cholecystectomy. Saudi Med J. 2008;29(10).
32. Sandhu T, Tanvatcharaphan P, Cheunjongkolkul V. Ondansetron versus metoclopramide in prophylaxis of nausea and vomiting for
laparoscopic cholecystectomy: a prospective double-blind randomized study. Asian journal of surgery. 2008;31(2):50–4.
33. Nakatani H, Naito Y, Ida M, Sato M, Okamoto N, Nishiwada T, et al. Association between intraoperative hypotension and postoperative nausea and vomiting: a retrospective analysis of 247 thyroidectomy cases. Brazilian Journal of
Anesthesiology (English Edition). 2021 Mar;S0104001421000944.
34. Eberhart L, Seeling W, Ulrich B, Morin A, Georgieff M. Dimenhydrinate and metoclopramide alone or in combination for prophylaxis of PONV. Canadian Journal of Anesthesia. 2000;47:780–5.
35. Quaynor H, Raeder J. Incidence and severity of postoperative nausea and vomiting are similar after metoclopramide 20 mg and ondansetron 8 mg given by the end of laparoscopic cholecystectomies. Acta anaesthesiologica scandinavica. 2002;46(1):109–13.
36. Wallenborn J, Gelbrich G, Bulst D, Behrends K, Wallenborn H, Rohrbach A, et al. Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone: randomised double blind multicentre trial. BMJ. 2006 Aug 12;333(7563):324.
37. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
38. Gulati, H. ., & Rana, S. . (2022). Habitat Preference and Current Threats to The Sarus Cranes Grus Antigone (Aves: Gruiformes:
Gruidae) In Important Bird Areas of Haryana, India: Implications for Determining Effective Conservation Actions. Journal Of Advanced Zoology, 43(1), 07–16. Retrieved from http://jazindia.com/index.php/jaz/article/view/110
39. Mokhtar, A. R. R. A. S. . (2022). Development Of Saponin Based Wettable Powder Formulation from Phaleria macrocarpa To Control Pomacea maculate. Journal Of Advanced Zoology, 43(1), 17–31. Retrieved from http://jazindia.com/index.php/jaz/article/view/111
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Mar 26, 2023
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Mojgan Rahimi, Hussein Majedi, Afzal Shamsi, Negar Eftekhar, & Rawaa Ali Kadhim. (2023). Comparison of incidents of nausea and vomiting between general anesthesia With Endotracheal tube and spinal anesthesia in cesarean sections. Journal of Population Therapeutics and Clinical Pharmacology, 30(4), 112-122. https://doi.org/10.47750/jptcp.2023.30.04.011
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How to Cite
Mojgan Rahimi, Hussein Majedi, Afzal Shamsi, Negar Eftekhar, & Rawaa Ali Kadhim. (2023). Comparison of incidents of nausea and vomiting between general anesthesia With Endotracheal tube and spinal anesthesia in cesarean sections. Journal of Population Therapeutics and Clinical Pharmacology, 30(4), 112-122. https://doi.org/10.47750/jptcp.2023.30.04.011