KETAMINE AND PETHEDINE FOR PREVENTION OF NAUSEA AND VOMITING IN CESAREAN SECTION UNDER SPINAL ANESTHESIA: COMPARATIVE STUDY

Abstract

Background: Nausea, retching and vomiting are common in cesarean section under spinal anesthesia, which is distressing for the parturient and interferes with the surgical procedure. Objectives: Evaluation of moderate sedation by ketamine and pethidine for prevention of intraoperative nausea and vomiting in parturient of cesarean section under spinal anesthesia in a comparative study with metoclopramide and ondansetron. Patients and methods: 80 patients divided into four groups; 1st group received 5ml normal saline as placebo, 2nd group received 10 mg metoclopramide diluted in 5 ml saline after clamping of the cord, 3rd group received 4 mg ondansetron diluted in 10 ml saline and the 4th group received 25 mg ketamine diluted to 5 ml saline and pethidine 25 mg diluted in another 5 ml saline by slowly intravenous injection after cord clamping. Results: Number of patients who suffered intraoperative nausea was less in sedation group (1, 5%) compared with 10 patients (50%) in placebo group, 7 patients (35%) in metoclopramide group and 6 patients (30%) in patients received ondansetron. Conclusion: Moderate sedation by ketamine and pethidine is more potent than metoclopramide and ondansetron for prevention of intraoperatie nausea and vomiting in cesarean section under spinal anesthesia.
Keywords: sedation, ketamine, pethidine, metoclopramide, ondansetron