Combined use of metoclopramide and dexamethasone as a prophylactic antiemetic in elective cesarean section under spinal anesthesia.

BACKGROUND Nausea and vomiting during regional anesthesia for cesarean section still remain a major problem. We compared the efficacy of dexamethasone plus metoclopramide with dexamethasone alone for preventing nausea and vomiting during and after spinal anesthesia for cesarean section in parturients. METHODS The study was performed in 72 full-term parturient women of ASA I & II (American Society of Anesthesiology Grade I & II), aged between 19 and 37 years with uncomplicated pregnancies. The group I (n = 36) received 8 mg of dexamethasone intravenously immediately when the surgery started, while group II (n = 36) received 8 mg of dexamethasone plus 10 mg of metoclopramide. The type and number of episodes of nausea and emesis were recorded, as well as any other adverse effects. RESULTS During the intraoperative period, a complete response (no emesis, no rescue) was noticed in 83% of patients in Group I and in 86% of patients in Group II. The incidence of nausea during both intra and postoperative periods was not different between the two groups. Metoclopramide was associated with impaired taste and smell and hot flushes. CONCLUSIONS 10 mg of metoclopramide did not improve the incidence of emetic symptoms in patients undergoing cesarean section when combined with 8 mg of dexamethasone.