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Sub-hypnotic dose of propofol as antiemetic prophylaxis attenuates intrathecal morphine-induced postoperative nausea and vomiting, and pruritus in parturient undergoing cesarean section - a randomized control trial.
BMC Anesthesiol 2019; 19(1):177BA

Abstract

BACKGROUND

Postoperative Nausea and Vomiting (PONV) is a dreadful and uncomfortable experience that significantly detracts patients' quality of life after surgery. This study aimed to examine the antiemetic effect of a single sub-hypnotic dose of propofol as prophylaxis for PONV.

METHOD

In this prospective, double-blind, randomized control trial, 345 parturients presented for elective cesarean section at the Obstetric unit of Tamale Teaching Hospital were recruited. Each recruited parturient was randomly assigned to one of three groups; Propofol group (n = 115) represented those who received propofol 0.5 mg/kg, Metoclopramide group (n = 115) represented those who received metoclopramide 10 mg and, Control group (n = 115) represented those who received 0.9% saline. Spinal anesthesia with 0.5% hyperbaric bupivacaine 7.5-10 mg, and intrathecal morphine 0.2 mg was employed for the anesthesia.

RESULTS

The data indicate that 108 (93.9%) parturients from the control group, 10 (8.7%) from the propofol group and 8 (7.0%) from the metoclopramide group experienced some incidence of PONV. There was no significant difference in the incidence of PONV (nausea, vomiting, and none) between the propofol and the metoclopramide groups (P = 0.99; 0.31; and 0.35 respectively). Parturients who received antiemetic agents were 105 (97.2%), 1 (10.0%) and 3 (37.5%) from the control, propofol and metoclopramide groups respectively. The data indicated that 98 (85.2%) parturients from the control, 3 (2.6%) from propofol group, and 100 (87.0%) from the metoclopramide group experienced some levels of pruritus. There was a significant difference in the incidence of pruritus (mild, moderate, and no pruritus) between the metoclopramide and propofol groups (P < 0.01; P < 0.01; and P < 0.01 respectively).

CONCLUSION

A sub-hypnotic dose of propofol is effective as metoclopramide in the prevention of PONV in parturient undergoing cesarean section under spinal anesthesia with intrathecal morphine. Sub-hypnotic dose of propofol significantly reduces the incidence of postoperative pruritus following intrathecal morphine use.

TRIAL REGISTRATION

Current control trial, registered at ISRCTN trial registry: ISRCTN15475205 . Date registered: 03/04/2019. Retrospectively registered.

Authors+Show Affiliations

Department of Anesthesia and Intensive Care, School of Medicine and Health Science, University for Development Studies, Tamale, Ghana. sylvanuskampo@yahoo.com. Department of Anesthesia, Tamale Teaching Hospital, Tamale, Ghana. sylvanuskampo@yahoo.com.Department of Anesthesia and Intensive Care, School of Medicine and Health Science, University for Development Studies, Tamale, Ghana.Department of Anesthesia, Tamale Teaching Hospital, Tamale, Ghana.Department of Physiology, Dalian Medical University, Dalian, China.Department of Surgery, School of Medicine and Health Science, University for Development Studies, Tamale, Ghana.Department of Anesthesia and Intensive Care, School of Medicine and Health Science, University for Development Studies, Tamale, Ghana. Department of Anesthesia, Tamale Teaching Hospital, Tamale, Ghana.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31521119

Citation

Kampo, Sylvanus, et al. "Sub-hypnotic Dose of Propofol as Antiemetic Prophylaxis Attenuates Intrathecal Morphine-induced Postoperative Nausea and Vomiting, and Pruritus in Parturient Undergoing Cesarean Section - a Randomized Control Trial." BMC Anesthesiology, vol. 19, no. 1, 2019, p. 177.
Kampo S, Afful AP, Mohammed S, et al. Sub-hypnotic dose of propofol as antiemetic prophylaxis attenuates intrathecal morphine-induced postoperative nausea and vomiting, and pruritus in parturient undergoing cesarean section - a randomized control trial. BMC Anesthesiol. 2019;19(1):177.
Kampo, S., Afful, A. P., Mohammed, S., Ntim, M., Buunaaim, A. D. B., & Anabah, T. W. (2019). Sub-hypnotic dose of propofol as antiemetic prophylaxis attenuates intrathecal morphine-induced postoperative nausea and vomiting, and pruritus in parturient undergoing cesarean section - a randomized control trial. BMC Anesthesiology, 19(1), p. 177. doi:10.1186/s12871-019-0847-y.
Kampo S, et al. Sub-hypnotic Dose of Propofol as Antiemetic Prophylaxis Attenuates Intrathecal Morphine-induced Postoperative Nausea and Vomiting, and Pruritus in Parturient Undergoing Cesarean Section - a Randomized Control Trial. BMC Anesthesiol. 2019 Sep 14;19(1):177. PubMed PMID: 31521119.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sub-hypnotic dose of propofol as antiemetic prophylaxis attenuates intrathecal morphine-induced postoperative nausea and vomiting, and pruritus in parturient undergoing cesarean section - a randomized control trial. AU - Kampo,Sylvanus, AU - Afful,Alfred Parker, AU - Mohammed,Shiraj, AU - Ntim,Michael, AU - Buunaaim,Alexis D B, AU - Anabah,Thomas Winsum, Y1 - 2019/09/14/ PY - 2019/03/03/received PY - 2019/09/05/accepted PY - 2019/9/16/entrez PY - 2019/9/16/pubmed PY - 2019/9/16/medline KW - Antiemetic KW - Cesarean section KW - Metoclopramide KW - Parturient KW - Postoperative nausea and vomiting KW - Prophylaxis KW - Propofol KW - Pruritus SP - 177 EP - 177 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 19 IS - 1 N2 - BACKGROUND: Postoperative Nausea and Vomiting (PONV) is a dreadful and uncomfortable experience that significantly detracts patients' quality of life after surgery. This study aimed to examine the antiemetic effect of a single sub-hypnotic dose of propofol as prophylaxis for PONV. METHOD: In this prospective, double-blind, randomized control trial, 345 parturients presented for elective cesarean section at the Obstetric unit of Tamale Teaching Hospital were recruited. Each recruited parturient was randomly assigned to one of three groups; Propofol group (n = 115) represented those who received propofol 0.5 mg/kg, Metoclopramide group (n = 115) represented those who received metoclopramide 10 mg and, Control group (n = 115) represented those who received 0.9% saline. Spinal anesthesia with 0.5% hyperbaric bupivacaine 7.5-10 mg, and intrathecal morphine 0.2 mg was employed for the anesthesia. RESULTS: The data indicate that 108 (93.9%) parturients from the control group, 10 (8.7%) from the propofol group and 8 (7.0%) from the metoclopramide group experienced some incidence of PONV. There was no significant difference in the incidence of PONV (nausea, vomiting, and none) between the propofol and the metoclopramide groups (P = 0.99; 0.31; and 0.35 respectively). Parturients who received antiemetic agents were 105 (97.2%), 1 (10.0%) and 3 (37.5%) from the control, propofol and metoclopramide groups respectively. The data indicated that 98 (85.2%) parturients from the control, 3 (2.6%) from propofol group, and 100 (87.0%) from the metoclopramide group experienced some levels of pruritus. There was a significant difference in the incidence of pruritus (mild, moderate, and no pruritus) between the metoclopramide and propofol groups (P < 0.01; P < 0.01; and P < 0.01 respectively). CONCLUSION: A sub-hypnotic dose of propofol is effective as metoclopramide in the prevention of PONV in parturient undergoing cesarean section under spinal anesthesia with intrathecal morphine. Sub-hypnotic dose of propofol significantly reduces the incidence of postoperative pruritus following intrathecal morphine use. TRIAL REGISTRATION: Current control trial, registered at ISRCTN trial registry: ISRCTN15475205 . Date registered: 03/04/2019. Retrospectively registered. SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/31521119/Sub-hypnotic_dose_of_propofol_as_antiemetic_prophylaxis_attenuates_intrathecal_morphine-induced_postoperative_nausea_and_vomiting,_and_pruritus_in_parturient_undergoing_cesarean_section_-_a_randomized_control_trial L2 - https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-019-0847-y DB - PRIME DP - Unbound Medicine ER -