Preventing Intraoperative Nausea and Vomiting During Cesarean Delivery under Spinal Anesthesia: A Comparison of Effects of Prophylactic Cyclizine, Metoclopramide, and Placebo

Abstract

Background: Nausea and vomiting are undesirable intraoperative events among women during cesarean delivery under subarachnoid block. Therefore, prophylaxis is recommended.

Aims: This study was undertaken to compare the effect of intravenous cyclizine with metoclopramide administered before achieving subarachnoid block.

Patients, Materials and Methods: The study was conducted among women booked for elective cesarean section using the subarachnoid technique. This is a prospective, randomized, double‑blinded study that compared the effect of single doses of cyclizine, metoclopramide, and placebo in preventing intraoperative nausea and vomiting among the selected patients. We obtained ethical clearance from the Hospital Research and Ethics Committee as well as written informed consent from each patient involved. The inclusion criteria include women aged 18–45 years with term singleton pregnancy scheduled for elective cesarean section, having the American Society of Anesthesiologists (ASA) physical status grades 1 and 2, with no known contraindications to spinal anesthesia, allergy to study drugs or local anesthetic agents. Patients were excluded if they declined, have a history of allergy to metoclopramide or cyclizine, have pregnancy-induced hypertension, hyperemesis gravidarium, motion sickness, gastrointestinal disease or glucose intolerance. One hundred and twenty parturients with ASA status I-II were recruited and assigned to three groups. All medications were administered intravenously: normal saline in Group I, metoclopramide in Group II, and cyclizine in Group III. Data were collected with study pro forma produced for the study. The Statistical Package for the Social Sciences (SPSS) Version 20.0 was used for analysis of the data collected. Results: The incidence of nausea was least in Group III. There were similar findings for retching and vomiting.

Conclusion: We, therefore, concluded that cyclizine is superior to metoclopramide in preventing nausea in women undergoing cesarean section under spinal anesthesia.