title: Glycopyrrolate reduces nausea during spinal anaesthesia for caesarean section without affecting neonatal outcome.
abstract: We have tested the hypotheses that glycopyrrolate, administered immediately before induction of subarachnoid anaesthesia for elective Caesarean section, reduces the incidence and severity of nausea, with no adverse effects on neonatal Apgar scores, in a double-blind, randomized, controlled study. Fifty women received either glycopyrrolate 200 micrograms or saline (placebo) i.v. during fluid preload, before induction of spinal anaesthesia with 2.5 ml of 0.5% isobaric bupivacaine. Patients were questioned directly regarding nausea at 3-min intervals throughout operation and asked to report symptoms as they arose. The severity of nausea was assessed using a verbal scoring system and was treated with increments of i.v. ephedrine and fluids. Patients in the group pretreated with glycopyrrolate reported a reduction in the frequency (P = 0.02) and severity (P = 0.03) of nausea. Glycopyrrolate also reduced the severity of hypotension, as evidenced by reduced ephedrine requirements (P = 0.02). There were no differences in neonatal Apgar scores between groups.
authors.affiliation: Department of Anaesthesia, Glasgow Royal Infirmary, UK.
authors.forename: D
authors.initials: D
authors.lastname: Ure
authors.forename: K S
authors.initials: KS
authors.lastname: James
authors.forename: M
authors.initials: M
authors.lastname: McNeill
authors.forename: J V
authors.initials: JV
authors.lastname: Booth
mesh_terms: D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D000932:Antiemetics / Q000627:therapeutic use*; D001034:Apgar Score; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006024:Glycopyrrolate / Q000627:therapeutic use*; D006801:Humans; D010276:Parasympatholytics / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011247:Pregnancy
chemical_list: D000932:Antiemetics; D010276:Parasympatholytics; D006024:Glycopyrrolate