Metoclopramide Versus Droperidol for Prevention of Nausea and Vomiting During Epidural Anesthesia for Cesarean Section

Chestnut, D.H.; Owen, Cindy L.; Geiger, M.; Bates, James N.; Choi, Won Joon; Östman, Pontus L.

doi:10.1097/00007611-198910000-00006

Cited by 22 publications

(7 citation statements)

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“…The incidence of emesis in this report is higher than previously published [1, 3, 10, 11]. The possible reasons for this difference are the routine exteriorisation of the uterus in this study, the use of spinal vs epidural anaesthetic, as reported in some of the other studies [1, 3], the routine administration of oral antacids in most of them [1, 3, 11] and the possibility of racial influence.…”

Section: Discussioncontrasting

confidence: 45%

“…Intra‐operative nausea and vomiting during Caesarean section under regional anaesthesia can be problematic and efforts should be made to control them [1, 3, 10, 11]. Our study showed ondansetron to be an effective anti‐emetic drug during the intra‐operative and immediate postoperative period for Caesarean section under spinal anaesthesia.…”

Section: Discussionmentioning

confidence: 73%

“…Nausea and vomiting during Caesarean section under regional anaesthesia can be disturbing to the patient and disrupting to the surgeon [1, 2]. Although ondansetron was found to be an effective anti‐emetic drug during Caesarean section under epidural anaesthesia [3], no report has been published examining the use of ondansetron in association with spinal anaesthesia.…”

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confidence: 99%

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Ondansetron versus placebo for the control of nausea and vomiting during Caesarean section under spinal anaesthesia

et al. 1999

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SummaryThe vasoactive properties of EMLA (eutectic mixture of local anaesthetic) and amethocaine were compared using Doppler colour ultrasound to measure vein diameter in 20 male volunteers. EMLA or amethocaine cream were applied over veins on the dorsum of the hand and vein diameter was measured prior to application of the preparations and at 1, 1.5 and 2 h after removal. Visual analogue scores for skin colour and vasodilatation were performed at 1 h. The results showed no significant difference in vein diameter between the EMLA and amethocaine groups. However, the amethocaine-treated hands were significantly more erythematous at 1 h (p`0.00002).Keywords Anaesthetics, local; topical, EMLA, amethocaine EMLA cream (Astra Pharmaceuticals), a eutectic mixture of the two amide local anaesthetics, lignocaine and prilocaine, is a topical local anaesthetic preparation for reducing the pain of intravenous cannulation. It is generally perceived that venous cannulation is more difficult after the application of EMLA cream due to local vasoconstriction. This has been substantiated by various studies; qualitative studies have assessed skin colour and skin blanching, and have blindly scored ease of cannulation [1][2][3]. More quantitative studies have measured local blood content using Doppler colour ultrasound and blood flow using laser Doppler flowmetry [4]. However, there have been no studies in which the diameter of superficial cutaneous veins deemed suitable for venous cannulation were measured directly, and therefore the effect of EMLA on venous diameter quantified.Strategies to reduce this vasoconstrictor action include combining EMLA with venodilators such as glyceral trinitrate (GTN) and removing EMLA for a period prior to venepuncture. The combination of EMLA and GTN has been shown to increase the ease of venepuncture [3, 5]. Removal of the EMLA at some time prior to venepuncture may also be effective in improving conditions for venous cannulation, but is limited by the short duration of topical anaesthesia provided by the EMLA cream.Amethocaine is an ester local anaesthetic which is now available as a topical preparation (Ametop, Smith and Nephew). It has been shown to provide more rapid and prolonged anaesthesia compared with EMLA [6, 7] and has also been reported to have a vasodilator action, which may be a direct action of the drug, or an indirect action due to histamine release. The vascular effects of amethocaine, however, have only been measured in an observational study in which dermal colour change was recorded [8]. We carried out a study to quantify and compare the vasoactive properties of EMLA and amethocaine cream, using Doppler colour ultrasound to measure venous diameter. MethodsAfter obtaining local ethics committee approval, 20 healthy male volunteers were recruited, gave written informed consent and took part in the study. The volunteers attended on two separate occasions at b7-day intervals. The study was a double-blind crossover design, with Anaesthesia, 1999, 54, 466-482 466ᮊ 1998 Blackwel...

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 73%

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confidence: 99%

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Ondansetron versus placebo for the control of nausea and vomiting during Caesarean section under spinal anaesthesia

et al. 1999

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“…metoclopramide, prochlorperazine, droperidol, domperidone) antagonise the effects of dopamine at the D2 receptors in the CTZ. They have a wide variety of associated side effects including sedation, agitation, and extra-pyramidal effects (Chestnut 1989). Droperidol has been associated with very rare, but potentially life threatening, cardiac arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

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

Griffiths

Gyte

Paranjothy

et al. 2012

Cochrane Database of Systematic Reviews

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“…Sample sizes were calculated prior to the start of the study protocol as follows. Based on the incidence of expected improvement by metoclopramide and droperidol [12][13][14], we determined that 40 members in each group would be required to provide 80% power to detect a 20% difference among three groups. Taking into account the known incidence of nausea [5], we recruited a total of 361 patients for the study.…”

Section: Introductionmentioning

confidence: 99%

Effect of flurbiprofen, metoclopramide and droperidol for nausea and emesis during cesarean section under spinal anesthesia

et al. 2011

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Metoclopramide Versus Droperidol for Prevention of Nausea and Vomiting During Epidural Anesthesia for Cesarean Section

Cited by 22 publications

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Ondansetron versus placebo for the control of nausea and vomiting during Caesarean section under spinal anaesthesia

Ondansetron versus placebo for the control of nausea and vomiting during Caesarean section under spinal anaesthesia

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

Effect of flurbiprofen, metoclopramide and droperidol for nausea and emesis during cesarean section under spinal anesthesia

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