Prophylactic Mirtazapine and Different Doses of Intrathecal Morphine in Preventing Nausea and Vomiting After Cesarean Section

Role of Prophylactic Mirtazapine and Different Doses of Intrathecal Morphine in Preventing Nausea and Vomiting After Cesarean Section: A Randomized Controlled Trial

The aim of this work was to evaluate the role of prophylactic mirtazapine and different doses of intrathecal morphine in preventing nausea and vomiting.

It is common practice to provide intrathecal morphine to alleviate postoperative pain because of its powerful and long-lasting analgesic effects. Mirtazapine is a noradrenergic and specific serotonergic antidepressant. It is anxiolytic by its antagonist of the 5HT2 receptor and is strongly sleep-inducing. Its antagonist at 5-hydroxytryptamine subtype 3 (5-HT3) receptor may help to prevent nausea and vomiting

Inclusion Criteria:

• Age 18-40 years.
• American Society of Anesthesiologists (ASA) physical status I-II.
• Scheduled for caesarean section under spinal anesthesia

Exclusion Criteria:

• Known hypersensitivity to mirtazapine.
• Gastrointestinal illness.
• Diabetes mellitus.
• Use of opioids or any medication with known antiemetic properties within 48 hours before surgery.
• Mental disorders.
• Spinal anesthesia contraindications.
• Taking antidepressants or antipsychotic medications.