| Abstract:Objective To explore the effect of multimodal-antiemetic therapy on perinatal nausea and vomiting in puerperas undergoing caesarean section with spinal anesthesia. Methods 150 puerperas from August 2014 to August 2015 in our hospital, aged 25.6±4.8, weighed 65.5±9.5kg, American Society of Anesthesiologists (ASA) class arranged fromⅠto Ⅱ and scheduled for caesarean section with spinal anesthesia, were chosen and randomly allocated to a multimodal-antiemetic therapy group (group M,n=75) or a control group (group C,n=75). Puerperas of the two groups were all injected intravenously with lidocaine at a dose of 0.1mg/kg to avoid injection pain. In group M, puerperas received prophylactic dexamethasone (10mg, iv) and tropisetron (2mg, iv) at 5 min before spinal anesthesia, were given with propofol at a dose of 0.5-1.0mg/kg after umbilical cord ligation, and received tropisetron (2mg, iv) and parecoxib sodium (40mg, iv) at the end of surgery. In group C, puerperas received same quantity of normal saline at 5min before spinal anesthesia and after umbilical cord ligation, and received ondansetron (4mg, iv) and same quantity of normal saline at the end of surgery. The incidence of intraoperative and postoperative nausea and vomiting (IONV and PONV) were recorded, and drug-related adverse effect was observed. Visual analogue scale (VAS) and pressing numbers of patient controlled intravenous analgesia (PCIA) were analyzed during 24 h after surgery. Results Compared to group C, the incidence of IONV and PONV was lower (P<0.05) in group M. The degree of nausea and vomiting of group M was lower (P<0.05) than that of group C. VAS and pressing numbers of PCIA of group M were both lower (P<0.05) than those of group C during 24h after surgery. There was no drug-related adverse effect in the two groups. Conclusion Multimodal-antiemetic therapy could significantly reduce the incidence of perinatal nausea and vomiting after caesarean section with spinal anesthesia, with higher safety in clinical practice. |
