title: Efficacy of ginger on intraoperative and postoperative nausea and vomiting in elective cesarean section patients.
abstract: OBJECTIVE
  To evaluate the efficacy of dry powdered ginger, given orally, on nausea and vomiting during and after an elective cesarean section performed under combined spinal epidural anesthesia.
  
  
  METHODS
  239 women, ginger (n=116) and placebo (n=123), who underwent elective cesarean section at term under combined spinal-epidural anesthesia were provided with standard preoperative antiemetic treatment in addition to a randomized study drug. They were given two capsules (1g each) of either dry powdered ginger or placebo, one capsule a half-hour before induction of anesthesia and the second 2h after surgery. The study was double-blinded and the incidences of nausea and vomiting were assessed both intraoperatively and postoperatively. Levels of pain and pruritus were also assessed postoperatively.
  
  
  RESULTS
  The intraoperative incidence of nausea was 52% and 61%, ginger versus placebo (p=0.149). The number of episodes of intraoperative nausea was less in the ginger group compared to placebo (mean difference was -0.396, 95% CI -0.738, -0.054) and the result was statistically significant (p=0.023). The incidence of intraoperative vomiting was 27.35% in the ginger group and 36.59% in the placebo group, and the difference was not statistically significant (p=0.126). The number of episodes of vomiting during surgery was less in the ginger group compared to placebo: (mean difference -0.158, 95% CI -0.626, 0.311) although statistically insignificant (p=0.505). Furthermore, postoperatively, there was no statistical difference in the incidence of nausea and vomiting assessed at 0, 2, 2 ½ and 24h after surgery. There were also no differences in postoperative pain or pruritus.
  
  
  CONCLUSIONS
  Ginger given in dry powdered form reduced the number of episodes of intraoperative nausea compared to a placebo, but it had no effect on incidence of nausea, vomiting, or pain during and after an elective cesarean section performed under combined spinal epidural anesthesia.
authors.affiliation: Department of Anesthesiology, New York Methodist Hospital, Brooklyn, NY 11215, USA. arunkalava@yahoo.com
authors.forename: Arun
authors.initials: A
authors.lastname: Kalava
authors.forename: Sandip J
authors.initials: SJ
authors.lastname: Darji
authors.forename: Allison
authors.initials: A
authors.lastname: Kalstein
authors.forename: Joel M
authors.initials: JM
authors.lastname: Yarmush
authors.forename: Joseph
authors.initials: J
authors.lastname: SchianodiCola
authors.forename: Jonathan
authors.initials: J
authors.lastname: Weinberg
mesh_terms: D000328:Adult; D000765:Anesthesia, Conduction / Q000009:adverse effects; D002585:Cesarean Section / Q000009:adverse effects; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D020939:Zingiber officinale; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D008517:Phytotherapy; D028321:Plant Preparations / Q000008:administration & dosage*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D028321:Plant Preparations
keywords: Cesarean section; Combined spinal epidural anesthesia; Ginger; Nausea and vomiting