Reduction of emetic symptoms during cesarean delivery with antiemetics: propofol at subhypnotic dose versus traditional antiemetics.
OBJECTIVE
To evaluate the efficacy and safety of propofol (at a subhypnotic dose), droperidol, and metoclopramide in reducing emetic symptoms during cesarean delivery.


METHODS
Randomized, double-blinded, placebo-controlled study.


METHODS
University hospital.


METHODS
100 ASA physical status I and II parturients undergoing cesarean delivery with spinal anesthesia.


METHODS
Patients received placebo (saline) followed by placebo (Intralipid(R)), placebo (saline) followed by propofol at a subhypnotic dose (1.0 mg/kg/hr), droperidol 1.25 mg followed by placebo (Intralipid(R)), or metoclopramide 10 mg followed by placebo (Intralipid(R)) intravenously (IV) immediately after clamping of the umbilical cord.


RESULTS
The percentage of patients who were emesis-free, which was defined as experiencing no nausea, retching, or vomiting, in the intraoperative, postdelivery period was 80% with propofol, 80% with droperidol, and 78% with metoclopramide (p < 0.05), compared with placebo (40%). Severity of nausea was less inpatients who received propofol than in those who received placebo (p < 0.05), and there were no differences seen among the droperidol, metoclopramide, and placebo groups. No clinically serious adverse events as a result of the study drugs were observed in any of the groups.


CONCLUSIONS
Prophylactic antiemetic efficacy of propofol at a subhypnotic dose (1.0 mg/kg/hr), droperidol 1.25 mg, and metoclopramide 10 mg is comparable in parturients undergoing cesarean delivery. Moreover, propofol at a subhypnotic dose is effective in the prevention of severe nausea.
Numazaki
Mitsuko
M
Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, 2-1-1 Amakubo, Tsukuba City, Ibaraki 305-8576, Japan.
Fujii
Yoshitaka
Y
D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D000932:Antiemetics / Q000008:administration & dosage*; D002585:Cesarean Section; D004311:Double-Blind Method; D004329:Droperidol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008787:Metoclopramide / Q000008:administration & dosage; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011247:Pregnancy; D015742:Propofol / Q000008:administration & dosage*
D000932:Antiemetics; D008787:Metoclopramide; D004329:Droperidol; D015742:Propofol