Prevention of emetic episodes during cesarean delivery performed under regional anesthesia in parturients. Current drug safety [Curr Drug Saf] Journal article

Nausea, retching, and vomiting are common in parturients undergoing cesarean delivery performed under regional anesthesia. These emetic episodes are distressing to the parturient and disturbing to the surgeon. Numerous antiemetics have been studied for the prevention of these emetic episodes in parturients scheduled for cesarean delivery. Traditional antiemetics, including butyrophenones (e.g., dropertidol), benzamide (e.g., metoclopramide), and anticholinergics (e.g., glycopyrrolate), are used for the control of these emetic episodes. Non-traditional antiemetics, propofol and dexamethasone, are available for the prevention of these emetic episodes. Serotonin receptor antagonists, ondansetron and granisetron, are more effective than traditional antiemetics for the prophylaxis against these emetic episodes. None of the available antiemetics are entirely effective, perhaps because most of them act through the blockade on one type of receptor. There is a possibility that combined antiemetics with different sites of activity would be more effective than one drug alone for the prevention of these emetic episodes. Antiemetic therapy with combined granisetron and dexamethasone or combined propofol and dexamethasone is highly effective for the prevention of these emetic episodes in parturients scheduled for cesarean delivery. Non-pharmacological technique includes acupressure at P6 (Nei-Kuwan) point. Overall, these pharmacological and non-pharmacological therapy reduces emetic episodes in parturients undergoing regional anesthesia for cesarean delivery. The clinician must weight the benefit of using pharmacological and non-pharmacological techniques for nausea, retching, and vomiting in parturients undergoing cesarean delivery performed under regional anesthesia.

Current drug safety [Curr Drug Saf]