Prophylactic multimodal antiemetic in women undergoing cesarean section under spinal anesthesia

BackgroundTo find out the cost effective antiemetic drug combination as a prophylaxis against nausea and vomiting during regional anesthesia for cesarean section.MethodsAfter the gaining of institutional ethical approval, 240 parturients scheduled for elective cesarean delivery under spinal anesthesia were randomly allocated to receive either 2 mg granisetron plus 8 mg dexamethasone (group II) IV immediately after clamping of the fetal umbilical cord or 2 mg midazolam plus 8 mg dexamethasone (group III) IV or placebo (group I).ResultsThe use of rescue antiemetic medication, which indicates either vomiting or severe nausea, in the post delivery period intraoperatively was 37%, 14%, 23% in group I, II and III, respectively. These values are significantly less than the corresponding values during the first 24 h after surgery which was 20%, 7%, 13%, respectively. No clinically serious adverse events were observed in any of the groups.ConclusionThe prophylactic use of a granisetron/dexamethasone combination is better than midazolam/dexamethasone for reducing nausea and vomiting in patients during and after spinal anesthesia for cesarean section.