Abstract:
Background: - Nausea and vomiting is multifactorial and common problem after spinal
anaesthesia for cesarean section which can be unpleasant and disturbing to the patient and
making surgery difficult. So that it is sensible to administer prophylaxis drugs with gastrokenitic
and antiemetic property for emergency caesarean section. Metoclopramide is believed to be
effective to reduce both the incidence and severity of intraoperative and early postoperative
nausea and vomiting for cesarean section in some studies. But its effectiveness of reducing the
risk of nausea and vomiting after spinal anesthesia for emergency cesarean section was
undetermined in our country, Ethiopia. There may be variation in the population demographics
and anaesthetic and surgical managements.
Objective: - the aim of this study was to assess the effectiveness of metoclopramide
prophylaxis for intraoperative and early postoperatve nausea and vomiting after emergency
cesarean section under spinal anaesthesia at GUH.
Methods: - prospective observational study was conducted to assess the effectiveness of
metoclopramide. Patients who took 10mg metoclopramide prophylaxis were grouped as group
A and without prophylaxis were grouped as group B. pretested observational checklist and
interview questionnaire were used to collect the data during CS, and at the 2st , 4nd and 6th hour
after cesarean section. Descriptive statistics was calculated for most variables. Student t test or
Mann Whitney U tests were used when appropriate. Chi-square and Fisher exact tests were used
to compare the proportion of categorical variables between the groups.
Results: - The prophylaxis group with 10mg metoclopramide (n=66) compared with non
prophylaxis group (n=66) resulted a significant reduction in the overall incidence of
intraoperative and early postoperative nausea and vomiting (25.8% vs. 48.5%, p=0.007). The
median score for nausea on a linear numeric rating scale were also reduced in the prophylaxis
group [0(0-7) vs. 0 (0-9), p=0.037] at the end of CS and [0(0-6) vs. 0 (0-9), p=0.006] at 2hour
and [0(0-6) vs. 0 (0-8), p=0.031] at 4hour. The frequency and number of vomiting episode was
also significantly reduced in the prophylaxis group.
Conclusion and recommendation: - Metoclopramide can reduce the incidence and severity
of nausea and vomiting when used as prophylaxis before emergency cesarean section under
spinal anesthesia.
