Metoclopramide VS. Ondansetron in the Prevention of Nausea and Vomiting During and After Elective Cesarean Section under Spinal Analgesia

Document Type : Original Article

Authors

1 Associate Professor, Department of Anesthesiology, Pain Management Fellowship, Anesthesiology Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

2 Anesthesiologist, Anesthesiology Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

3 Professor, Department of Anesthesiology, Cardiac and Anesthesia Fellowship, Anesthesiology Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

4 Associate Professor, Department of Anesthesiology, Cardiac and Anesthesia Fellowship, Anesthesiology Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

5 Assistant Professor, Department of Anesthesiology, Anesthesiology Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

6 B.Sc. of Anesthesiology, Anesthesiology Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

10.22038/ijogi.2024.75221.5871

Abstract

Introduction: Nausea and vomiting are one of the most common side effects of caesarean section with spinal anesthesia. The present study was conducted with aim to compare the effect of intravenous metoclopramide and ondansetron in preventing nausea and vomiting in elective cesarean section with spinal analgesia.
Methods: This double-blind randomized clinical trial study with a control group was conducted in 2020-2021 on 150 pregnant women 18-40 year’s candidates for elective cesarean section in Bandarabbas city. The patients were randomly divided into three groups. Five minutes before spinal anesthesia, Group I received IV metoclopramide and Group II received IV Ondansetron and group III received IV normal saline. The incidence and number of episodes of nausea and vomiting, systolic and diastolic blood pressure, and heart rate was compared at 1,2,4 and 6 hours after the spinal anesthesia. The amount of ephedrine consumption was also compared in the three groups. Data were analyzed by Stata software. P˂0.05 was considered significant.         
Results: The incidence of nausea and/or vomiting during the first hour after spinal anesthesia in the control group was 50%, in the ondansetron group 40%, and in the metoclopramide group 22%. In total, the risk of nausea and/or vomiting during the first hour after spinal anesthesia in the metoclopramide group was 56 % lower than that in the control group. In terms of the incidence of nausea and vomiting in the following hours, no statistically significant difference was observed between the groups (p>0.05). In addition, there was no statistically significant difference among the groups in terms of the incidence of hypotension and the amount of ephedrine consumed (p>0.05).
Conclusion: Intravenous injection of metoclopramide 10 mg before spinal anesthesia in elective cesarean section reduces the incidence of nausea and/or vomiting in the first hour after spinal anesthesia more than ondansetron.

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References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 4
June 2025
Pages 1-9

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