Comparison prophylactic glycopyrrolate, dexamethasone, metoclopramide in control of nausea and vomiting after spinal anaesthesia for caesarean delivery

Background: The effects of spinal anesthesia on women in their labour period are different from those observed in non-obstetric patients. The distribution of the anaesthetic drug in cerebrospinal fluid (CSF) is less predictable than non-obstetric patients, Moreover side effects including hypotension, nausea and vomiting are more common. Aims: To compare the efficacy of inj glyocopyrolate 0.2 mg iv, inj dexamethasone 8mg i.v, inj Metoclorpromide 10mg i.v in control of post-operative nausea and vomiting after spinal anaesthesia for caesarean delivery Method and Material: All consenting women were explained and women were randomly allocated in to four groups of 20 each, Group A inj.Glycopyrrolate 0.2 mg, Group B, inj. Dexamethasone 8 mg, Group C inj. Metoclopramide 10 mg and Group D (n=20) inj. Normal saline 2m1. Level of spinal block, hemodynemic changes, incidence of intraoperative and post-operative nausea and vomiting were noted in all four groups. The incidences of nausea and vomiting were compared in different groups and the differences were tested for significance by calculating ‘z’ value. A ‘p’ value <0.05 was considered significant. Results: The overall (intraoperative & postoperative) incidence of nausea and vomiting which was 20% in group A, 35% in group B, 50% in group C and 60% in group D. Statistical analysis showed that the all three drugs decrease incidence of nausea and vomiting, but glycopyrrolte found to be more effective in preventing nausea and vomiting. Conclusion: The incidences of nausea and vomiting were high fallowing spinal anesthesia during caesarean delivery. Administration of glycopyrrolate intravenously before spinal in caesarean section effectively control the incidence and severity of intraoperative and early postoperative nausea and vomiting compared to the non-treatment group.