Study of Propofol for Control of Nausea and Vomiting During Caesarian Delivery Under Spinal Anasthesia.

Abstract

The incidence of nausea-vomiting during and immediately after caesarean delivery with spinal anesthesia is a common occurrence and
annoying problem to all concerned. The abrupt diaphragmatic contractions present in emesis are uncomfortable to the patient. They may cause
protrusion of the abdominal viscera, rendering surgery more difficult and increasing the risk of visceral injuries. If the stomach is full, aspiration is
an additional hazard. Therefore, it is advisable to prevent it during spinal anesthesia for a caesarean section. Our aim of this study is to evaluate
the effectiveness of propofol in controlling nausea and vomiting during cesarean delivery under spinal anesthesia. Our Objective is to assess the
magnitude of intraoperative and postoperative nausea, retching, and vomiting in parturients and to evaluate the efficacy of propofol at
subhypnotic doses for reducing emetic episodes in parturients. After getting clearance from the institutional ethical committee, the study was
conducted at S C B Medical College, Cuttack, Odisha, from November 2019 to October 2021 over 2 years. It was a prospective, randomized,
double-blind, placebo-controlled study. The result of the study indicates the incidence of intraoperative emetic episodes in caesarean delivery is
very high. In the study, 6% of patients in the propofol group experienced intra-operative vomiting, while in the placebo group, it was
30%(p=0.004). Propofol at 1mg/kg/hr infusion, administered immediately after clamping the umbilical cord, significantly decreased the incidence
and severity of nausea, retching, and vomiting and the need for rescue antiemetic therapy compared with placebo.