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Current Reviews in Clinical and Experimental Pharmacology

Author(s): Jahanbakhsh R. Nejadi, Mahnaz Shamseh, Nooshin Ronasi, Mehdi Birjandi and Arash Karimi*

DOI: 10.2174/1574884715666200302122800

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Comparison of the Effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

Page: [117 - 122] Pages: 6

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Abstract

Background: Postoperative Nausea and Vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study was to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia.

Methods: This double-blind clinical trial study was performed on patients who were referred to Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire were used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software.

Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The odd ration of PONV was 20.67, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106.

Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in C-section surgical candidates.

Keywords: Dexamethasone, ondansetron, nausea, vomiting, spinal, cesarean.

Graphical Abstract

[1]
Reza Moradkhani M, Karimi A, Zarei Z, Vahabi S. The relationship between the phases of the menstrual cycle on the incidence and severity of headache after spinal anesthesia. Surg J 2019; 5(03): e126-30.
[http://dx.doi.org/10.1055/s-0039-1696967]
[2]
Aagaard K, Ma J, Antony KM, Ganu R, Petrosino J, Versalovic J. The placenta harbors a unique microbiome. Sci Transl Med 2014; 6(237): 237ra65-37ra65..
[http://dx.doi.org/10.1126/scitranslmed.3008599]
[3]
Shaikh SI, Nagarekha D, Hegade G, Marutheesh M. Postoperative nausea and vomiting: A simple yet complex problem. Anesth Essays Res 2016; 10(3): 388-96.
[http://dx.doi.org/10.4103/0259-1162.179310] [PMID: 27746521]
[4]
Alizadeh R, Mireskandari S-M, Azarshahin M, et al. Oral clonidine premedication reduces nausea and vomiting in children after appendectomy. Iran J Pediatr 2012; 22(3): 399-403.
[PMID: 23400517]
[5]
Lorzadeh N, Samimi S, Birjandi M. Association of fetal gender with maternal serum β-hCG and testosterone in normotensive and preeclamptic pregnancies. Majallah-i Zanan, Mamai va Nazai-i Iran 2010; 13(1): 13-9.
[6]
Kalani N, Zabetian H, Sanie MS, et al. The effect of ondansetron and dexamethasone on nausea and vomiting under spinal anesthesia. World J Plast Surg 2017; 6(1): 88-93.
[PMID: 28289619]
[7]
Yari F, Ghafarzadeh M, Vahabi S, Khadish A. The efficacy of adding dexamethazone to clomiphene citrate in the treatment of polycystic ovary syndrome and infertility. Iran J Reprod Med 2014; 12(6): 93.
[8]
Pécora FST, Malbouisson LMS, Torres MLA. Supplemental oxygen and the incidence of perioperative nausea and vomiting in cesarean sections under subarachnoid block. Rev Bras Anestesiol 2009; 59(5): 558-69.
[http://dx.doi.org/10.1016/S0034-7094(09)70080-7] [PMID: 19784511]
[9]
Balki M, Carvalho JC. Intraoperative nausea and vomiting during cesarean section under regional anesthesia. Int J Obstet Anesth 2005; 14(3): 230-41.
[http://dx.doi.org/10.1016/j.ijoa.2004.12.004] [PMID: 15935649]
[10]
Lorzadeh N, Kazemirad S, Lorzadeh M, Najafi S. Comparison of the effect of oral and intravenous fluid therapy on women with oligohydramnios. Res J Obstet Gynecol 2008; 1(1): 25-9.
[http://dx.doi.org/10.3923/rjog.2008.25.29]
[11]
Demirhan A, Tekelioglu YU, Akkaya A, et al. Antiemetic effects of dexamethasone and ondansetron combination during cesarean sections under spinal anaesthesia. Afr Health Sci 2013; 13(2): 475-82.
[http://dx.doi.org/10.4314/ahs.v13i2.39] [PMID: 24235952]
[12]
Jain R, Sharma R. A comparative study of effects of glycopyrrolate and ondansetron on nausea and vomiting in cesarean section under spinal anesthesia. Anesth Essays Res 2015; 9(3): 348-52.
[http://dx.doi.org/10.4103/0259-1162.159725] [PMID: 26712972]
[13]
Jadon A, Sinha N, Agrawal A, Jain P. Effect of intravenous dexamethasone on Postoperative Nausea-Vomiting (PONV) after intrathecal morphine during caesarean section. SOJAPM 2016; 3(1): 1-5.
[14]
Beiranvand S, Karimi A, Vahabi S, Amin-Bidokhti A. Comparison of the mean minimum dose of bolus oxytocin for proper uterine contraction during cesarean section. Curr Clin Pharmacol 2019; 14(3): 208-13.
[http://dx.doi.org/10.2174/1574884714666190524100214] [PMID: 31124424]
[15]
Aghsaiefard Z, Hossenifard Z, Alizadeh R, Ramim T. The relationship between hemoglobin level with PTH level and dialysis adequacy in chronic hemodialysis patients. Tehran Univ Med J 2018; 76(4): 257-64.
[16]
Rasooli S, Moslemi F, Gogazadeh M. Preventing nausea and vomiting using ondansetron and metoclopramide-phenylephrine in cesarean section using spinal anesthesia. Crescent J Med Biol Sci 2019; 6(1): 61-5.
[17]
Feyer P, Jahn F, Jordan K. Prophylactic management of radiation-induced nausea and vomiting. BioMed Res Int 2015; 2015: 893013-13.
[http://dx.doi.org/10.1155/2015/893013] [PMID: 26425557]
[18]
Esmaeili S, Alizadeh R, Shoar S, Naderan M, Shoar N. Acupuncture in preventing postoperative anaesthesia-related sore throat: A comparison with no acupuncture. Acupunct Med 2013; 31(3): 272-5.
[http://dx.doi.org/10.1136/acupmed-2012-010249] [PMID: 23665888]
[19]
Chu CC, Hsing CH, Shieh JP, Chien CC, Ho CM, Wang JJ. The cellular mechanisms of the antiemetic action of dexamethasone and related glucocorticoids against vomiting. Eur J Pharmacol 2014; 722: 48-54.
[http://dx.doi.org/10.1016/j.ejphar.2013.10.008] [PMID: 24184695]
[20]
Alizadeh R, Shariat A, Nakhostin Ansari N, et al. Office-based exercise therapy as a non-pharmacological treatment for discogenic low back pain among army staff. Iran J Public Health 2018; 47(12): 1969-70.
[PMID: 30788318]
[21]
Swaro S, Karan D, Banerjee A. Comparison of palonosetron, dexamethasone, and palonosetron plus dexamethasone as prophylactic antiemetic and antipruritic drug in patients receiving intrathecal morphine for lower segment cesarean section. Anesth Essays Res 2018; 12(2): 322-7. [Online First: Epub Date
[http://dx.doi.org/10.4103/aer.AER_183_17] [PMID: 29962591]
[22]
Akbariasbagh F, Lorzadeh N, Azmoodeh A, Ghaseminejad A, Mohamadpoor J, Kazemirad S. Association among diameter and volume of follicles, oocyte maturity, and competence in intracytoplasmic sperm injection cycles. Minerva Ginecol 2015; 67(5): 397-403.
[PMID: 26491821]
[23]
Lorzadeh N, Ghasem Nejad A, Mohmad Pour J. The Effect of metformin on outcome of Intrauterine Insemination (IUI) in insulin non-resistant infertile women with polycystic ovarian syndrome. Majallah-i Zanan, Mamai va Nazai-i Iran 2014; 17(128): 1-11.