Prophylactic Diclectin® reduces the incidence of postoperative vomiting

Abstract

B Ba ac ck kg gr ro ou un nd d: : Diclectin® (DCL) is an effective antiemetic used for relief of nausea and vomiting in pregnancy. It is unknown whether DCL is effective in the prevention of postoperative nausea and vomiting (PONV).M Me et th ho od ds s: : We conducted a randomized, stratified, double-blind placebo-controlled trial to examine the incidence of PONV in women undergoing elective laparoscopic tubal ligation in the day surgery setting. DCL (doxylamine succinate 10 mg and pyridoxine hydrochloride 10 mg) was administered orally the night before surgery, the morning of surgery, and upon hospital discharge.Results: We enrolled 146 women in the trial, 127 of whom were included in the effectiveness analysis and 102 of whom were included in the efficacy analysis. We did not detect a difference in the incidence of nausea and vomiting in the first six hours postoperatively after adjusting for additional antiemetics administered. Patients receiving DCL as compared with placebo were significantly less likely to experience vomiting six to 24 hr postoperatively [5/59 (8.5%) vs 14/55 (25.4%), P < 0.017]. Treated patients tended to return to work earlier than those who received placebo (1.74 vs 3.7 days P = NS).C Co on nc cl lu us si io on n: : Perioperative oral DCL reduces the incidence of postoperative vomiting in women undergoing elective laparoscopic tubal ligation, and may accelerate return to work. Contexte : Le Diclectin® (DCL) est un antiémétique efficace contre les nausées et les vomissements pendant la grossesse. On ne sait pas s'il peut prévenir les nausées et vomissements postopératoires (NVPO). Méthode

Zingiber officinale (ginger) might be better than vitamin B6 for treating nausea in pregnancy

“…A recent Cochrane systematic review concluded that vitamin B 6 (pyridoxine) on its own may work, but the evidence for its efficacy for nausea associated with pregnancy is not very strong 1 . Other studies report it is most effective as part of a combination regimen 2, 3 . The need for an active comparator in general, and the choice of vitamin B 6 as the specific active comparator, were not adequately justified in this study.…”

The comparative preemptive analgesic efficacy of addition of vitamin B complex to gabapentin versus gabapentin alone in women undergoing cesarean section under spinal anesthesia

“…[2,9] Furthermore, vitamin B6 has been known to possess antiemetic effects since 1942. [34–39] Hypotheses to describe the antiemetic effects of pyridoxine include prevention/treatment of vitamin B6 deficiency, intrinsic antinausea properties, and/or augmentation the antinausea properties of antihistamines. [34–39] …”