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Transdermal scopolamine for prevention of intrathecal morphine-induced nausea and vomiting after cesarean delivery.
Anesth Analg. 2007 Sep; 105(3):764-9.A&A

Abstract

BACKGROUND

Intrathecal morphine for cesarean delivery provides excellent postoperative analgesia but is associated with significant nausea and vomiting.

METHODS

We compared the antiemetic efficacy of transdermal scopolamine, IV ondansetron, and placebo during the first 24 h postoperatively. Two-hundred forty women undergoing cesarean delivery under spinal anesthesia were randomly allocated, in a double-blind study design, to receive transdermal scopolamine 1.5 mg, ondansetron 4 mg, or placebo at the time of cord clamping.

RESULTS

Our study showed that the overall rates for all emesis were 59.3% in the placebo group and were reduced to 40% in the scopolamine group and 41.8% in the ondansetron group. The greatest reduction in emesis in the scopolamine group when compared with placebo was in the 6-24 h time period.

CONCLUSION

Scopolamine is an effective medication for prophylactic use in parturients receiving intrathecal morphine while undergoing cesarean delivery. Its use, however, was associated with a higher incidence of side effects such as dry mouth and blurry vision.

Authors+Show Affiliations

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17717237

Citation

Harnett, Miriam J P., et al. "Transdermal Scopolamine for Prevention of Intrathecal Morphine-induced Nausea and Vomiting After Cesarean Delivery." Anesthesia and Analgesia, vol. 105, no. 3, 2007, pp. 764-9.
Harnett MJ, O'Rourke N, Walsh M, et al. Transdermal scopolamine for prevention of intrathecal morphine-induced nausea and vomiting after cesarean delivery. Anesth Analg. 2007;105(3):764-9.
Harnett, M. J., O'Rourke, N., Walsh, M., Carabuena, J. M., & Segal, S. (2007). Transdermal scopolamine for prevention of intrathecal morphine-induced nausea and vomiting after cesarean delivery. Anesthesia and Analgesia, 105(3), 764-9.
Harnett MJ, et al. Transdermal Scopolamine for Prevention of Intrathecal Morphine-induced Nausea and Vomiting After Cesarean Delivery. Anesth Analg. 2007;105(3):764-9. PubMed PMID: 17717237.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transdermal scopolamine for prevention of intrathecal morphine-induced nausea and vomiting after cesarean delivery. AU - Harnett,Miriam J P, AU - O'Rourke,Nollag, AU - Walsh,Mary, AU - Carabuena,Jean Marie, AU - Segal,Scott, PY - 2007/8/25/pubmed PY - 2007/9/19/medline PY - 2007/8/25/entrez SP - 764 EP - 9 JF - Anesthesia and analgesia JO - Anesth Analg VL - 105 IS - 3 N2 - BACKGROUND: Intrathecal morphine for cesarean delivery provides excellent postoperative analgesia but is associated with significant nausea and vomiting. METHODS: We compared the antiemetic efficacy of transdermal scopolamine, IV ondansetron, and placebo during the first 24 h postoperatively. Two-hundred forty women undergoing cesarean delivery under spinal anesthesia were randomly allocated, in a double-blind study design, to receive transdermal scopolamine 1.5 mg, ondansetron 4 mg, or placebo at the time of cord clamping. RESULTS: Our study showed that the overall rates for all emesis were 59.3% in the placebo group and were reduced to 40% in the scopolamine group and 41.8% in the ondansetron group. The greatest reduction in emesis in the scopolamine group when compared with placebo was in the 6-24 h time period. CONCLUSION: Scopolamine is an effective medication for prophylactic use in parturients receiving intrathecal morphine while undergoing cesarean delivery. Its use, however, was associated with a higher incidence of side effects such as dry mouth and blurry vision. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/17717237/Transdermal_scopolamine_for_prevention_of_intrathecal_morphine_induced_nausea_and_vomiting_after_cesarean_delivery_ L2 - https://doi.org/10.1213/01.ane.0000277494.30502.db DB - PRIME DP - Unbound Medicine ER -