Transdermal scopolamine for prevention of intrathecal morphine-induced nausea and vomiting after cesarean delivery.
BACKGROUND
Intrathecal morphine for cesarean delivery provides excellent postoperative analgesia but is associated with significant nausea and vomiting.


METHODS
We compared the antiemetic efficacy of transdermal scopolamine, IV ondansetron, and placebo during the first 24 h postoperatively. Two-hundred forty women undergoing cesarean delivery under spinal anesthesia were randomly allocated, in a double-blind study design, to receive transdermal scopolamine 1.5 mg, ondansetron 4 mg, or placebo at the time of cord clamping.


RESULTS
Our study showed that the overall rates for all emesis were 59.3% in the placebo group and were reduced to 40% in the scopolamine group and 41.8% in the ondansetron group. The greatest reduction in emesis in the scopolamine group when compared with placebo was in the 6-24 h time period.


CONCLUSIONS
Scopolamine is an effective medication for prophylactic use in parturients receiving intrathecal morphine while undergoing cesarean delivery. Its use, however, was associated with a higher incidence of side effects such as dry mouth and blurry vision.
Harnett
Miriam J P
MJ
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
O'Rourke
Nollag
N
Walsh
Mary
M
Carabuena
Jean Marie
JM
Segal
Scott
S
D000279:Administration, Cutaneous; D016362:Analgesia, Obstetrical; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D000932:Antiemetics / Q000008:administration & dosage* / Q000009:adverse effects; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D007278:Injections, Spinal; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D017294:Ondansetron / Q000008:administration & dosage* / Q000009:adverse effects; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D012601:Scopolamine / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D000932:Antiemetics; D017294:Ondansetron; D009020:Morphine; D012601:Scopolamine