Subhypnotic Doses of Propofol Versus Midazolam to Prevent Nausea and Vomiting During Spinal Anesthesia for Caesarean Section

Abstract

Background 
 Nausea and vomiting is a common complication in parturients with cesarean delivery under spinal anesthesia it may causes significant distress to the patient and increases the chance of aspiration pneumonitis, it also affects the surgical procedure. Many drugs have been used to prevent this complication but none proved to be effective to abolish it completely.
 Objectives 
 Subhypnotic dose of Midazolam or Propofol were evaluated to prevent intraoperative nausea and vomiting during elective cesarean section under spinal anesthesia.
 Methods
 This study is a randomized control clinical trial, after local ethical committee approval A 93 consenting (ASAII ) parturients, who underwent spinal anesthesia for caesarean section were divided randomly into three groups received Propofol (20 milligram bolus and 0.1 milligram /kilogram/hour by infusion immediately after the bolus dose, 30 parturients ), Midazolam (1 milligram bolus and 1 milligram/hour by infusion after bolus dose, 31 parturients ), and placebo (saline, 32 parturients ) intravenously after umbilical cord clamping. Bupivacaine 0.5% (12.5-15 milligram) used for spinal anesthesia. Intraoperative and post delivery emetic episodes were recorded.
 Results
 The incidence of nausea and vomiting was significantly less in the propofol and Midazolam groups in compared to placebo group. There was insignificant difference between Propofol and Midazolam group in postoperative nausea and vomiting (P = 0.616) and there were no significant hemodynamic changes in all the groups. 
 Conclusion
 The use of Propofol is as effective as Midazolam in decreasing nausea and vomiting during Caesarean section under spinal anesthesia.