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OBSTETRIC ANESTHESIA

Granisetron/Dexamethasone Combination for Reducing Nausea and Vomiting During and After Spinal Anesthesia for Cesarean Section

Yoshitaka Fujii, MD^*, Yuhji Saitoh, MD, Hiroyoshi Tanaka, MD, and Hidenori Toyooka, MD^*

*Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine; and Department of Anesthesiology, Toride Kyodo General Hospital, Toride City, Ibaraki, Japan

Address correspondence and reprint requests to Y. Fujii, Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, 2-1-1, Amakubo, Tsukuba City, Ibaraki 305, Japan.

We compared the efficacy of granisetron plus dexamethasone with that of granisetron alone for preventing nausea and vomiting in parturients undergoing cesarean section under spinal anesthesia. In a randomized, double-blinded manner, 120 patients received either granisetron 3 mg (Group I, n = 60) or granisetron 3 mg plus dexamethasone 8 mg (Group II, n = 60) IV immediately after clamping of the fetal umbilical cord. A complete response, defined as no emetic symptoms and no need for another rescue antiemetic medication in the intraoperative, postdelivery period was 83% in Group I and 98% in Group II (P = 0.008); the corresponding rates during the first 24 h after surgery was 85% and 98% (P = 0.016). No clinically serious adverse events were observed in any of the groups. In conclusion, the prophylactic use of a granisetron/dexameth- asone combination is more effective than granisetron alone for reducing nausea and vomiting in patients during and after spinal anesthesia for cesarean section.

Implications: Intraoperative, postdelivery, and postoperative nausea and vomiting are distressing to patients undergoing cesarean section under spinal anesthesia. The combination of granisetron plus dexamethasone was evaluated and found to be effective for preventing these emetic symptoms.

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