Prediction of intraoperative nausea and vomiting in caesarean delivery under regional anaesthesia

Abstract

ObjectivesThis study aimed to predict patients who have caesarean operations under regional anaesthesia and are at risk for intraoperative nausea and vomiting (IONV), for ultimately prompting anaesthetists and surgeons to take preventive measures.MethodsThis was a retrospective study on 209 patients who had caesarean section under spinal-epidural combined regional anaesthesia. The relevant medical history, such as severe nausea and vomiting in the first trimester, smoking, a history of motion sickness, and premenstrual syndrome (PMS), were obtained from the patients’ records and interviews.ResultsPatients who had a female neonate, a history of severe nausea and vomiting in the first trimester, and a history of PMS and motion sickness before pregnancy experienced a significantly higher rate of IONV. Smokers were less susceptible to IONV, but this was not significant.ConclusionThis study shows that some factors in the medical history of a patient can help identify those who are more likely to suffer from IONV.

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

“…Anesthesia-related risk factors ( Table 1 – Table 3 ) include the use of opioids, volatile agents, nitrous oxide (which increases the risk for postoperative vomiting), and high doses of neostigmine for the reversal of residual neuromuscular blockade 32 , 38 , 47 – 51 . General anesthesia is associated with a higher incidence of PONV compared with regional anesthesia 35 , 52 , 53 secondary to the greater requirement for opioid medication to control postoperative pain after general anesthesia in both adults and children 35 , 54 . The performance of peripheral nerve blocks 55 – 58 , ganglion block 59 , and wound infiltration with local anesthetic 60 has been shown to decrease the incidence of PONV.…”

Magnitude And Associated Factors of Intraoperative Nausea And Vomiting Among parturients who gave birth with Cesarean Section under Spinal Anesthesia At Hospitals in South Gondar Zone, Ethiopia

“…Also a study done on 209 patients to predict the possible factors of IONV revealed that the overall incidence of IONV was 77 (36.8%) patients experienced nausea during the caesarean operation and 19 (9.1%) suffered from vomiting (10).…”

“…Increased intragastric pressure due to gravid utres, hypotension, sretching the peritoneum (exteriorization of the uterus), excessive surgical manipulation and visceral stimulation, using opioids, using uterotonic agents, visceral type of pain, and the patient's mental status play a role and place the patient at high risk for IONV (3,9,10). Hypotension associated with spinal,epidural, and spinal-epidural (combined) anaesthesia is a particularly important contributing factor for IONV (4,7,11).…”

“…To prevent IONV during cesarean section, blood pressure must be closely monitored, use of opioids must be kept to a minimum, the operative technique must be gentle with minimum displacement of the uterus (not exteriorising through an incision), and uterotonics and antibiotics must be administered in dilute and slow infusions (10,12). Knowing magnitude and factors causing IONV helps urgent need of safety and treatment in the service of anesthesia to prevent its impact on surgery and patient satisfaction.…”

Effect of Gum Chewing and Coffee Consumption on Intestinal Motility in Caesarean Sections

“…Thus, the time to passage of first flatus and defaecation are two of the main factors that determine the postoperative patient comfort [1]. Autonomic nervous system changes that cause reduction in postoperative bowel movements are observed most commonly in caesarean section [2][3][4]. Gastrointestinal dysfunction causes accumulation of gas and secretions in the intestines resulting in nausea, vomiting, abdominal distension, pain, and ileus [5].…”