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Prevention of postoperative nausea and vomiting after intrathecal morphine for Cesarean section: a randomized comparison of dexamethasone, droperidol, and a combination.
Int J Obstet Anesth. 2007 Apr; 16(2):122-7.IJ

Abstract

BACKGROUND

Intrathecal morphine provides good analgesia after cesarean delivery but the side effects include nausea and vomiting. Low-dose droperidol (0.625 mg) combined with dexamethasone 4 mg is postulated to have an additive antiemetic effect with less side effects. We therefore compared single doses of dexamethasone and droperidol alone with a low-dose combination of the two, to prevent spinal morphine-induced nausea and vomiting after cesarean section.

METHODS

In a double-blind study, 120 women undergoing elective cesarean section under spinal anesthesia (using 0.5% bupivacaine 10 mg and morphine 0.2 mg) were allocated randomly to receive dexamethasone 8 mg, droperidol 1.25 mg, dexamethasone 4 mg and droperidol 0.625 mg, or placebo, before the end of surgery. The incidences of nausea and vomiting, sedative score, pain score, and side effects were recorded.

RESULTS

The incidence of nausea and vomiting within 6 h postoperatively was lower and incidence of no nausea and vomiting for 24 h postoperatively was significantly higher for the combination group compared to the placebo group and the dexamethasone only group. Sedation scores within 3 h postoperatively and incidence of restlessness for the combination group were significantly lower than in the droperidol only group.

CONCLUSION

An additive antiemetic effect and no significant side effects were shown for the combination of dexamethasone 4 mg and droperidol 0.625 mg. This combination was more effective than either dexamethasone 8 mg or droperidol 1.25 mg alone in preventing nausea and vomiting after spinal anesthesia using 0.5% bupivacaine and morphine 0.2 mg.

Authors+Show Affiliations

Department of Anesthesiology, Kaohsiung Municipal Min-Sheng Hospital, National Yang-Ming University School of Medicine, Taiwan, ROC.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17275282

Citation

Wu, J I., et al. "Prevention of Postoperative Nausea and Vomiting After Intrathecal Morphine for Cesarean Section: a Randomized Comparison of Dexamethasone, Droperidol, and a Combination." International Journal of Obstetric Anesthesia, vol. 16, no. 2, 2007, pp. 122-7.
Wu JI, Lo Y, Chia YY, et al. Prevention of postoperative nausea and vomiting after intrathecal morphine for Cesarean section: a randomized comparison of dexamethasone, droperidol, and a combination. Int J Obstet Anesth. 2007;16(2):122-7.
Wu, J. I., Lo, Y., Chia, Y. Y., Liu, K., Fong, W. P., Yang, L. C., & Tan, P. H. (2007). Prevention of postoperative nausea and vomiting after intrathecal morphine for Cesarean section: a randomized comparison of dexamethasone, droperidol, and a combination. International Journal of Obstetric Anesthesia, 16(2), 122-7.
Wu JI, et al. Prevention of Postoperative Nausea and Vomiting After Intrathecal Morphine for Cesarean Section: a Randomized Comparison of Dexamethasone, Droperidol, and a Combination. Int J Obstet Anesth. 2007;16(2):122-7. PubMed PMID: 17275282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of postoperative nausea and vomiting after intrathecal morphine for Cesarean section: a randomized comparison of dexamethasone, droperidol, and a combination. AU - Wu,J I, AU - Lo,Y, AU - Chia,Y Y, AU - Liu,K, AU - Fong,W P, AU - Yang,L C, AU - Tan,P H, Y1 - 2007/02/01/ PY - 2006/06/01/received PY - 2006/11/01/accepted PY - 2007/2/6/pubmed PY - 2007/7/13/medline PY - 2007/2/6/entrez SP - 122 EP - 7 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 16 IS - 2 N2 - BACKGROUND: Intrathecal morphine provides good analgesia after cesarean delivery but the side effects include nausea and vomiting. Low-dose droperidol (0.625 mg) combined with dexamethasone 4 mg is postulated to have an additive antiemetic effect with less side effects. We therefore compared single doses of dexamethasone and droperidol alone with a low-dose combination of the two, to prevent spinal morphine-induced nausea and vomiting after cesarean section. METHODS: In a double-blind study, 120 women undergoing elective cesarean section under spinal anesthesia (using 0.5% bupivacaine 10 mg and morphine 0.2 mg) were allocated randomly to receive dexamethasone 8 mg, droperidol 1.25 mg, dexamethasone 4 mg and droperidol 0.625 mg, or placebo, before the end of surgery. The incidences of nausea and vomiting, sedative score, pain score, and side effects were recorded. RESULTS: The incidence of nausea and vomiting within 6 h postoperatively was lower and incidence of no nausea and vomiting for 24 h postoperatively was significantly higher for the combination group compared to the placebo group and the dexamethasone only group. Sedation scores within 3 h postoperatively and incidence of restlessness for the combination group were significantly lower than in the droperidol only group. CONCLUSION: An additive antiemetic effect and no significant side effects were shown for the combination of dexamethasone 4 mg and droperidol 0.625 mg. This combination was more effective than either dexamethasone 8 mg or droperidol 1.25 mg alone in preventing nausea and vomiting after spinal anesthesia using 0.5% bupivacaine and morphine 0.2 mg. SN - 0959-289X UR - https://www.unboundmedicine.com/medline/citation/17275282/Prevention_of_postoperative_nausea_and_vomiting_after_intrathecal_morphine_for_Cesarean_section:_a_randomized_comparison_of_dexamethasone_droperidol_and_a_combination_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(06)00199-3 DB - PRIME DP - Unbound Medicine ER -