Scopolamine Patch and Acupressure Point P6 Stimulation for Reduction of Nausea and Vomiting During Cesarean Section
Condition: Nausea; Vomiting; Satisfaction
MeSH terms: Nausea; Vomiting
Study type: Interventional
Phase: Phase 4

Summary: 
      The purpose of this study is to compare the effectiveness of reducing intra-cesarean section
      nausea and vomiting with regional anesthesia in subjects who will receive scopolamine patch
      with acupressure point P6 stimulation versus subjects that receive just scopolamine patch
      versus subjects that receive just acupressure point P6 stimulation.
    

Detailed description: 
      Nausea and vomiting are very common and unpleasant events experienced during cesarean section
      under regional anesthesia and in the postoperative period following cesarean section. These
      side effects are distressing for both the parturient and her family. In addition,
      intraoperative vomiting causes significant challenges for the surgeon, such as increased
      procedure length, increased risk of bleeding, increased risk of gastric content aspiration,
      and potential surgical trauma.

      To combat the nausea and vomiting seen in all above anesthetic modalities, but to a greater
      degree in regional anesthesia, a number of pharmacological interventions are currently used
      with varying degrees of effectiveness in the perioperative period. These medications come
      from a wide range of drug classes including serotonin and dopamine receptor antagonists,
      corticosteroids, antihistamines, sedatives and anticholinergics.

      In our study, we would like to compare the effectiveness of antiemetic agents or technique
      which cause less severe adverse reactions to the mother and her fetus. Out of the available
      pharmacological agents for reduction of intra-cesarean section nausea and vomiting,
      transdermal scopolamine patch is one of the safest medications. We would like to compare the
      effectiveness of the transdermal scopolamine patch with acupressure point P6 stimulation
      versus just transdermal scopolamine patch versus just acupressure point P6 stimulation.
    

Intervention name(s): scopolamine patch; acupressure point P6
Intervention type(s): Drug; Device
Intervention description(s): Group I (n=80): Will receive scopolamine patch placement on the skin behind the right ear 1 hour before initiation of the regional anesthesia for the duration of surgery. The time of the application of the patch will be recorded, and the time of the start of the surgery will be recorded. The last time point for evaluation of patient's nausea/vomiting will be when the patient arrives to the post anesthesia care unit. A member of the research team will remove the patch from the patient and properly dispose the patch upon arrival to the post anesthesia care unit.; Group II (n=80): Will receive acupressure point P6 stimulation. This is a stimulation of the chi channel at the master of the heart (MH8 position) at the small depression of the volar surface of the distal right forearm just above the crest of the wrist. The device will be put on the patients in the operating room prior to administration of the regional anesthesia and will be removed after the cesarean section is complete. The device will be removed from the patient in the operating room, before the patient is transported to the recovery room. Patients will receive continuous stimulation at a level that is comfortable for her prior to administration of the standardized regional anesthesia.
Other intervention name(s): Transderm-Scop; Scopace; Maldemar
Intervention MeSH terms: Scopolamine; Butylscopolammonium Bromide
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: cesarean section; acupressure point p6; scopolamine patch