Prophylactic effect of sub hypnotic dose of propofol in the prevention of Intraoperative post-delivery nausea and vomiting in mothers undergoing elective caesarean section under spinal anaesthesia at ALERT referral hospital, Addis Ababa, Ethiopia, 2020,a prospective cohort study.
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Date
2020-06
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Addis Abeba University
Abstract
Background: Post-delivery Nausea and vomiting is one of the most common and unpleasant
events affecting parturients undergoing caesarean delivery under spinal anaesthesia. It
causes
Parturient discomfort, it interferes with surgery, elevates the risk of bleeding as well as
increasing the risk of pulmonary aspiration.
Objective: To assess the prophylactic effects of sub hypnotic dose of propofol in preventing
the occurrence and severity of post-delivery nausea and vomiting in parturients who
underwent elective Caesarean Section under Spinal Anaesthesia
Methods: A prospective cohort study was done at Alert Referral hospital on 62 Parturients
who came for elective caesarean section under spinal anaesthesia by using systematic
random sampling method. Incidence of nausea and vomiting, severity of nausea and use of
rescue anti emetic were assessed. Distribution of numerical data analysed using Shapiro
Wilk test. Independent t-test and Mann Whitney U test were used to compare symmetric and
asymmetric data, respectively. Categorical variable between two groups were analysed using
Chi Square or fisher exact test as appropriate. P value <0.05 was considered as statistically
significant.
Result: The incidence of PDNV was significantly lower in the propofol group when
compared to non-propofol group the first 10 minutes post-delivery period (41.9% vs.74.2%)
(P =0.01). The severity of nausea was statistically greater in the non propofol group
compared to propofol group (32.3% in non propofol group experienced moderate nausea
versus 3.2%) in the propofol group (p=0.006) and severe nausea was (0% Vs 22.7%, p=0.11)
Less Intraoperative rescue antiemetic metoclopramide consumption was observed in sub
hypnotic propofol group compared to non-propofol group. The median rescue ant emetic
consumption was 10 mg in non-propofol group and 0 mg in propofol group (p<0.001).
Conclusion and recommendations: Administration of prophylactic sub hypnotic dose
of propofol (20 mg IV bolus) after delivery of the baby and clamping of the umbilical cord
was effective in the prevention and immediate treatment of post-delivery nausea and vomiting
and reduce need for Intraoperative rescue antiemetic for parturients undergoing elective
caesarean section under spinal anaesthesia.
The researcher recommend the use of prophylactic intravenous sub hypnotic dose of propofol
(20 mg) for parturients undergoing elective caesarean section under spinal anaesthesia for
the prevention of Intraoperative post-delivery nausea and vomiting.
Description
Keywords
Caesarean section, spinal anaesthesia, nausea vomiting