Prevention of Intraoperative Nausea and Vomiting During Cesarean Section

The Effect of Adding Metoclopramide and Ondansetron to a Prophylactic Phenylephrine Infusion for the Management of Nausea and Vomiting Associated With Spinal Anesthesia for Cesarean Section

The study investigates the incidence of intraoperative nausea and vomiting under spinal anesthesia using a phenylephrine infusion with and without prophylactic antiemetics.

Inclusion Criteria:

• English speaking ASA I-II non-laboring women with single gestations ≥36 weeks
• Scheduled or unscheduled cesarean delivery under spinal anesthesia
• Height: 5 feet-5 feet 11 in.

Exclusion Criteria:

• Laboring women needing an emergency cesarean delivery

  • Subjects less than 18 years of age
  • Receipt of a drug with antiemetic properties in the 24 hours prior to cesarean section
  • Allergy to ondansetron, or metoclopramide
  • Severe hypertensive disease of pregnancy defined as systolic blood pressure (SBP)>160mmHg, diastolic blood pressure (DBP)>110mmHg requiring antihypertensive treatment or associated with significant proteinuria.
  • Severe Cardiac disease in pregnancy with marked functional limitations
  • Diabetes type I
  • Patients on Monoamine Oxidase Inhibitors or Tricyclic Antidepressants
  • Morbid obesity (body mass index (BMI)>45)
  • Inclusion in another anesthetic study involving drug administration