Intrathecal Atropine Versus Intravenous Ondasetron in Post Operative Nausea Due to Intrathecal Morphine

Intrathecal Atropine Versus Preoperative Intravenous Ondasetron for Prevention of Postoperative Nausea and Vomiting Due to Intrathecal Morphine in Perineal Surgery

To compare between intrathecal atropine versus preoperative administration of IV ondansetron in decreasing incidence of post operative nausea and vomiting related to intrathecal opioids in post operative period in perineal surgery as regard : efficacy and side effects .

Inclusion Criteria:

• Age between ( 18 - 45 ) years.
• Body mass index between ( 18.5 - 35 )
• patients undergoing perineal surgery as anal fissure , piles and rectocele
• patients receiving bupivacaine ( 20 mg / 4 ml ) as spinal anesthesia
• Patinets with physical status 1 or 2 according to ASA classification

Exclusion Criteria:

• Patient refusal .
• Any contraindication of neuraxial block as : coagulopathy , skin infection at injection site or bacteremia , hypovolemia and shock , history of allergy to L.A , sever aortic stenosis or mitral stenosis ……… etc
• Patients with physical status other than 1 and 2 according to ASA classification
• Those with history of nausea and vomiting , also those who received anti emetic drugs in last 2 hours of operation .
• Allergy to any of the drug included in this study .