Intrathecal Atropine to Prevent Postoperative Nausea and Vomiting

Study Overview
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Brief Summary
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optimal postoperative pain control with intrathecal morphine, with proper prevention of postoperative nausea and vomiting. Dexamethasone, and or atropine could offer some protection against nausea and vomiting.

Detailed Description
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One of the gold standards for analgesia following cesarean delivery is intrathecal morphine, which is not devoid of complications namely postoperative nausea and vomiting. We evaluated the antiemetic effect of intravenous dexamethasone combined with intrathecal atropine after cesarean delivery under spinal bupivacaine plus morphine anesthesia.

Official Title
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Intravenous Dexamethasone Combined With Intrathecal Atropine to Prevent Morphine-related Nausea and Vomiting After Cesarean Delivery: A Randomized Double-blinded Study

Conditions
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Postoperative Nausea

Intervention / Treatment
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* Drug: Intrathecal atropine
* Drug: dexamethasone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: females 18-40 years of age elective cesarean delivery under bupivacaine spinal anesthesia Exclusion Criteria: renal disease preeclampsia liver disease cardiac disease Coagulopathy chronic cough nausea vomiting patient refusal

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Atropine group<br>Atropine group (A): Patients received intrathecal heavy Marcaine, 2 ml, 0.5% plus 300 µg morphine and 100 µg atropine (0.5ml), and intravenous injection of 2ml normal saline. | Drug: Intrathecal atropine<br>* 100ug intrathecal atropine will be injected with spinal anesthesia<br>|
| Active Comparator: Dexamethasone group<br>Dexamethasone group (D): Patients received intrathecal heavy Marcaine 2 ml, 0.5% plus 300 µg morphine (0.5ml), and intravenous 8 mg dexamethasone (2ml). | Drug: dexamethasone<br>* intravenous 8 mg dexamethasone (2ml).<br>|
| Active Comparator: Dexamethasone and Atropine group<br>Dexamethasone and Atropine group (DA): Patients received intrathecally as group A, plus intravenous injection of 2 ml, dexamethasone 8 mg. Postoperative follow-up of both nausea and vomiting was done over 24 hours postoperative. | Drug: Intrathecal atropine<br>* 100ug intrathecal atropine will be injected with spinal anesthesia<br>Drug: dexamethasone<br>* intravenous 8 mg dexamethasone (2ml).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative nausea | Monitoring scale of nausea and vomiting | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Postoperative Nuasea