Publication:

Effect of dexamethasone versus dexamethasone with granisetron in prevention of nausea and vomiting in caesarian section under spinal anesthesia: a randomized double blind study

Background Postoperative nausea and vomiting (PONV) are a common occurrence in patients undergoing caesarean section under spinal anaesthesia. It can lead to adverse events like pain, bleeding, dehydration, electrolyte imbalance, aspiration pneumonia etc.

Methods This study was aimed at comparing the effectiveness of dexamethasone alone with dexamethasone with granisetron in prevention of PONV in patients undergoing caesarean section under spinal anaesthesia. This was a double blinded prospective randomized controlled trial conducted on 60 pregnant mothers undergoing elective caesarean section under spinal anaesthesia. One group of patients (n=30) received dexamethasone 8 mg intravenously whereas the other group received dexamethasone 8 mg plus granisetron 2 mg intravenously after baby was delivered and cord clamped. Patients were then observed for a period of 24 hrs postoperatively.

Results Upon comparison of PONV score between both groups, at 0-2 hrs dexamethasone-granisetron (PONV 0=50%, 1=33.3%, 2=13.3%, 3=3.3%) showed better control than dexamethasone alone (PONV 0=40%, 1=36.7%, 2=16.7%, 3=6.7%). Similar results were seen at 2-24 hrs with dexamethasone-granisetron (PONV 0=83.3%, 1=16.7%, 2=0%, 3=0%) having better score than dexamethasone (PONV 0=66.7%, 1=26.7%, 2=3.3%, 3=3.3%). Need for rescue antiemetic was less in dexamethasone+granisetron (5 out of 30=16.7%) compared to dexamethasone (10 out of 30=33.3%). No major side effects were seen.

Conclusions Our study shows that dexamethasone combined with granisetron is a safe and effective prophylactic antiemetic in pregnant ladies undergoing caesarean section under spinal anaesthesia, compared to monotherapy of dexamethasone.