Glycopyrrolate Reduces Nausea During Spinal Anaesthesia for Caesarean Section Without Affecting Neonatal Outcome

Ure, D. S.; James, Kenneth S.; McNeill, M. J.; Booth, John V.

doi:10.1097/00132586-199910000-00034

Cited by 5 publications

(6 citation statements)

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“…The incidence of nausea in control group is similar to incidence reported by D. Ure et al 4 The lower rate of nausea in midazolam group is similar to finding of O. Tarhan et al 5 The mechanism of anti-emetic effect of midazolam is not well known. Midazolam acts on chemoreceptor trigger zone to reduce synthesis, release and postsynaptic effect of dopamine.…”

Section: Discussionsupporting

confidence: 85%

Effects of intravenous midazolam during spinal anaesthesia for caesarian section

Deka

Talukdar

Laha

et al. 2016

Int J Basic Clin Pharmacol

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Section: Discussionsupporting

confidence: 85%

Effects of intravenous midazolam during spinal anaesthesia for caesarian section

Deka

Talukdar

Laha

et al. 2016

Int J Basic Clin Pharmacol

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“…In addition, the absorption of IM atropine may be unpredictable, and the onset may have been too slow in comparison to the onset of hypotension after SA. Recently, another anticholinergic agent, glycopyrrolate, when given IV increased HR after SA and reduced the severity of hypotension (14). In our study, the number needed to treat to prevent one case of significant hypotension in the small-dose atropine group was four, and the number needed to treat in the large-dose atropine group was three.…”

Section: Discussionmentioning

confidence: 50%

The Use of Intravenous Atropine After a Saline Infusion in the Prevention of Spinal Anesthesia-Induced Hypotension in Elderly Patients

Lim

Choi

et al. 2000

Anesthesia & Analgesia

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We investigated the efficacy of IV atropine for preventing spinal anesthesia-induced hypotension in elderly patients. Seventy-five patients undergoing transurethral prostate or bladder surgery were randomized to receive either placebo (n ϭ 25), atropine 5 g/kg (smalldose atropine, n ϭ 25) or atropine 10 g/kg (large-dose atropine, n ϭ 25) after the induction of spinal anesthesia. All the patients received an IV infusion of 10 mL/kg 0.9% normal saline over 10 min before the induction of anesthesia. The systolic blood pressure decreased in all three groups after spinal anesthesia. There was a significant increase in the mean heart rate in both atropine groups as compared to the placebo group (placebo group: 78 bpm, 95% confidence interval [CI]: 76.6 -78.5; smalldose atropine group: 86 bpm, 95% CI: 83.9 -88.8; largedose atropine group: 97 bpm, 95% CI: 94.5-100.3; P ϭ 0.001). There was a significant decrease in the incidence of hypotension in patients who received atropine (placebo group: 76%, small-dose atropine group: 52%, large-dose atropine group: 40%, P ϭ 0.03). The mean dose of ephedrine required was significantly decreased in the atropine groups (placebo group: 12.2 mg [sdϭ 10.5], small-dose atropine group: 7.4 mg [sdϭ 10.0], large-dose atropine group: 5.4 mg [sdϭ 8.7 mg], P ϭ 0.048). The total amount of IV fluid and number of patients requiring metaraminol in addition to 30 mg of ephedrine were not significantly different among the three groups. Significant side effects, such as confusion, ST segment changes or angina were not detected in any of the patients. We conclude that IV atropine may be a useful supplement to the existing methods in preventing hypotension induced by spinal anesthesia.

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“…Transdermal scopolamine's onset of action is approximately 2-4 hours; therefore, it should be applied the evening before surgery.I Other anticholinergic agents, such as atropine and glycopyrrolate, are generally not used for PONV.30 However, there is some evidence to support the use of glycopyrrolate. 31…”

Section: Antlcholinergicsmentioning

confidence: 99%

Prevention of Postoperative Nausea and Vomiting

2007

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The first step in the prevention of PONV is assessment and reduction of risk factors. Although nonpharmacologic therapies may play a role in the treatment of PONV, the mainstay of therapy for PONV is pharmacologic modalities. Patients at moderate to high risk for PONV need prophylactic antiemetic therapy. High-risk patients may require combination therapy with 2 or 3 agents from different antiemetic classes. Rescue antiemetic therapy is needed by patients who actually develop PONV. The agents of choice in such cases should be from antiemetic classes different from those used for prophylaxis of PONV.

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Glycopyrrolate Reduces Nausea During Spinal Anaesthesia for Caesarean Section Without Affecting Neonatal Outcome

Cited by 5 publications

References 0 publications

Effects of intravenous midazolam during spinal anaesthesia for caesarian section

Effects of intravenous midazolam during spinal anaesthesia for caesarian section

The Use of Intravenous Atropine After a Saline Infusion in the Prevention of Spinal Anesthesia-Induced Hypotension in Elderly Patients

Prevention of Postoperative Nausea and Vomiting

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