Interventions for preventing nausea and vomiting in women undergoing regional anaesthesia for caesarean section

Griffiths, J. D.; Gyte, Gillian ML; Popham, P.; Williams, Kacey; Paranjothy, Shantini; Broughton, Hannah K.; Brown, H. C.; Thomas, Justin

doi:10.1002/14651858.cd007579.pub3

Cited by 14 publications

(12 citation statements)

References 230 publications

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“…In the present study, the incidence of IONV in group S (61%) was consistent with previous studies, from 30% to 70% in placebo groups. [1–6] This indicates that we could evaluate IONV correctly as the presence of the intraoperative feeling of nausea/vomiting during CS. Although we assumed that the use of other criteria to define IONV, such as NRS score of ≥5, might affect the results, no significant difference was found in the degree of intraoperative nausea.…”

Section: Discussionmentioning

confidence: 95%

“…Intraoperative nausea and vomiting (IONV) is a common symptom experienced during cesarean section (CS) delivery and has been found to occur in 30% to 70% of patients in a placebo group undergoing elective CS delivery. [1][2][3][4][5][6] IONV occurs during regional anesthesia, causes considerable discomfort to the patient, and increases the risk of surgical complications induced by sudden movement. Therefore, prevention of IONV leads to improvement of anesthesia quality and patient safety during CS.…”

Section: Introductionmentioning

confidence: 99%

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Epidural administration of 2% Mepivacaine after spinal anesthesia does not prevent intraoperative nausea and vomiting during cesarean section: A prospective, double-blinded, randomized controlled trial

Kita¹,

Furutani

Baba

2022

Medicine

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Background: Intraoperative nausea and vomiting (IONV) is a common symptom during cesarean section (CS) delivery causing significant discomfort to patients. Combined spinal and epidural anesthesia (CSEA) can provide both intraoperative anesthesia and postoperative analgesia. During CSEA, it is reasonable to administer local anesthetics to the epidural space before patient complaints to compensate for the diminished effect of spinal anesthesia. Therefore, we hypothesized that intraoperative epidural administration of 2% mepivacaine would reduce the incidence of IONV.Methods: Patients who were scheduled for elective CS were randomly allocated to 2 groups. Patients and all clinical staff except for an attending anesthesiologist were blinded to the allocation. After the epidural catheter was inserted at the T11-12 or T12-L1 interspace, spinal anesthesia was performed at the L2-3 or L3-4 interspace to intrathecally administer 10 mg of 0.5% hyperbaric bupivacaine. Twenty min after spinal anesthesia, either 5 mL of 2% mepivacaine (group M) or saline (group S) was administered through an epidural catheter. Vasopressors were administered prophylactically to keep both the systolic blood pressure ≥ 80 % of the baseline value with the absolute value ≥ 90 mm Hg and the mean blood pressure ≥ 60 mm Hg. The primary endpoint was the incidence of IONV. The secondary endpoints were degree of nausea, the degree and incidence of pain, and Bromage score.Results: Ninety patients were randomized, and 3 patients were excluded from the final analysis. There was no significant difference in the incidence of IONV between the groups (58% in group M and 61% in group S, respectively, P = .82). In contrast, the incidence and degree of intraoperative pain in group M were significantly lower compared to group S. In addition, the incidence of rescue epidural administration of fentanyl (18% vs 47%) or mepivacaine (2.3% vs 25%) for intraoperative pain was lower in group M compared to group S.Conclusions: Our results indicate that epidural administration of 2% mepivacaine 20 minutes after spinal anesthesia does not reduce the incidence of IONV in CS under CSEA. However, intraoperative epidural administration of 2% mepivacaine was found to improve intraoperative pain.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Epidural administration of 2% Mepivacaine after spinal anesthesia does not prevent intraoperative nausea and vomiting during cesarean section: A prospective, double-blinded, randomized controlled trial

Kita¹,

Furutani

Baba

2022

Medicine

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“…The Cochrane review demonstrates that acupressure probably has efficacy in reducing nausea and vomiting in women in labor, however, the stand-out evidence was generally low warranting further research ( 131 ). Acupressure may reduce pain intensity for pain management during labor ( 132 , 133 ).…”

Section: Discussionmentioning

confidence: 99%

Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map

Fogaça

Portella²,

Ghelman³

et al. 2021

Front. Public Health

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Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes.Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects.Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia.Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.

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“…Multimodal approach is more effective than the single agent use. Combination of 5-HT 3 antagonists with dopamine antagonists or corticosteroids was reported more effective than 5-HT 3 antagonist alone (56).…”

Section: A Prevention Of Nausea and Vomitingmentioning

confidence: 99%

“…Antiemetic agents are also useful to prevent intraoperative and postoperative nausea and vomiting. Dopamine antagonists, 5-HT 3 antagonists, sedatives, corticosteroids, antihistamines, and anticholinergic agents are effective to reduce nausea and vomiting (55,56). Multimodal approach is more effective than the single agent use.…”

Section: A Prevention Of Nausea and Vomitingmentioning

confidence: 99%

Sezaryen Doğumda Gelişmiş Cerrahi Sonrası İyileşme Programları: Literatür Taraması

Kinay

İbanoğlu

Üstün

2022

Türk Kadın Sağlığı Ve Neonatoloji Dergisi

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Gelişmiş Cerrahi Sonrası İyileşme (ERAS) programları, 2000’li yılların başından beri birçok cerrahi uzmanlık dalında operasyon sonuçlarını iyileştirmiştir. Bu multidisipliner standart bakım programı, cerrahi hastalarının preoperatif, intraoperatif, postoperatif bakımını optimize etmeyi amaçlamıştır. Yeni yayınlar ERAS protokollerinin sezaryen doğumlarda başarıyla uygulandığını göstermiştir. Sezaryen doğumda ERAS programının temel öğeleri; antenatal eğitim/danışmanlık, cerrahi öncesi tıbbi optimizasyon, anestezi öncesi medikasyon, sınırlı açlık süresi, karbonhidrat suplementasyonu, intraoperatif anestezi yönetimi, cerrahi alan enfeksiyon profilaksisi, normotermi ve övoleminin sürdürülmesi, uygun cerrahi teknik, yenidoğan bakımı, postoperatif analjezi, bulantı ve kusmanın önlenmesi, erken beslenme, erken mobilizasyon, tromboembolizm profilaksisi, glukoz yönetimi, idrar yönetimi ve taburculuk danışmanlığıdır. Bu öğelerin uygulanması, maternal /neonatal sonuçların iyileşmesi ve hastanede kalış süresinin azalması ile sonuçlanmıştır. Bununla birlikte, bu konudaki mevcut literatür sezaryen doğum için standartlaştırılmış, küresel olarak uygulanan bir ERAS protokolü geliştirmek için yeterli değildir. Bakım programını ve önerileri geliştirmek için daha fazla çalışmaya ihtiyaç vardır.

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Interventions for preventing nausea and vomiting in women undergoing regional anaesthesia for caesarean section

Cited by 14 publications

References 230 publications

Epidural administration of 2% Mepivacaine after spinal anesthesia does not prevent intraoperative nausea and vomiting during cesarean section: A prospective, double-blinded, randomized controlled trial

Epidural administration of 2% Mepivacaine after spinal anesthesia does not prevent intraoperative nausea and vomiting during cesarean section: A prospective, double-blinded, randomized controlled trial

Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map

Sezaryen Doğumda Gelişmiş Cerrahi Sonrası İyileşme Programları: Literatür Taraması

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