Background: Pregnant women are always considered full stomach with high incidence of nausea and vomiting. Anti-emetic efficacy of Ondansetron has been proved in various studies. The aim of this present study is to evaluate efficacy and safety of chewing gum as an alternative to Ondansetron in prevention of postoperative nausea and vomiting (PONV) in parturients undergoing elective LSCS under spinal anesthesia. Materials and Methods: One hundred pregnant women who were found eligible as per inclusion and exclusion criteria were randomized into two equal groups by simple randomization into Group A (n=50) who were given sugar free chewing gum which was to be chewed for 30 minutes three times a day starting immediately after cesarean section and Group B (n=50) who received Inj. Ondanse tron 4mg twice a day post operatively. The outcome measures were episodes of post-operative nausea and vomiting at 6, 12, 18 and 24 hours in both groups, relief of PONV and acceptability of treatment. The secondary outcome measures time to first flatus. Statistical analysis was done through relevant tests using SPSS 16.0. Results: There was no statistically significant difference between the two groups in terms of demographic characteristics such as age, gravidity parity, duration of surgery and type of cesarean section. The incidence of nausea and vomiting was significantly less in Group A compared with Group B at 6 and 12 hours post operatively (p < 0.001). There was no significant difference of this variable at 18 and 24 hours in both groups. The mean average of the first passage of flatus in group A was 20.3±2.01 hours versus 29.6±2.51 hours in Group B (P<0.0001) was significantly shorter compared to the group B. Conclusion: Gum chewing after cesarean section is safe, well tolerated, and acceptable for prevention of post-operative nausea and vomiting and rapid resumption of intestinal motility and has potential impact on reducing the overall healthcare costs in case of routine implementation.

Postoperative pain, nausea and vomiting remain the most common and unpleasant complications in women undergoing cesarean delivery, in turn hindering the mother’s ability to care for the newborn and herself. Traditional methods to alleviate pain such as systemic and neuraxial opioids, nonsteroidal anti-inflammatory drugs, often in combination, are used to treat pain in this population.