The effect of adding "epinephrine" to the combination of "intrathecal Lidocaine- fentanyl " on nausea and vomiting after the surgery of elective cesarean section

Document Type : Original Article


1 Associate Professor, Department of Anesthesiology, Anesthesia in Cardiac Surgery Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Postoperative nausea and vomiting (PONV) is one of the most common complaints of the patients. The prevention of postoperative nausea and vomiting leads to improving the patients' satisfaction, prevention of delayed discharge from the recovery, the unexpected prolonged hospitalization and reducing the cost of health care. This study was performed with aim to provide better prevention of postoperative nausea and vomiting after elective cesarean section (C/S).
Methods: This clinical trial study was performed on 100 term pregnant women with ASA class I-II scheduled for elective C/S with intrathecal anesthesia. the subjects were divided into two groups based on random number table. For control, Intrathecal lidocaine-Fentanyl and for intervention group, a combination of Intrathecal lidocaine-Fentanyl-Epinephrine were administered. Recording of vital signs, nausea and vomiting was continued until recovery of sensorimotor block level under T10. Data was analyzed using SPSS statistical software (version 11) by Kolmogrov - Smirnov test, independent t test, Chi-square, and Mann-Whitney tests. PResults: There was no statistically significant difference between two groups in terms of nausea (P=0.80) and vomiting (P=0.21), age (0.69), parity (P=0.94), Ephedrine injection time (P=0.29), need to atropine injection (P=0.50), need to metoclopramide injection (P=0.085). Mean decrease of blood pressure in control group was significantly higher than intervention group (P=0.004). Newborns in two groups had an Apgar score of 8-9.
Conclusion: Adding 0.2 mg Epinephrine to a combination of  Intrathecal lidocaine-Fentanyl does not cause significant difference in the incidence of postoperative nausea and vomiting


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