A comparative study between propofol and propofol plus dexamethasone as antiemetic during cesarean section under spinal anesthesia

Background: Some of the common problems observed during cesarean section under regional anesthesia are nausea, retching, and vomiting. In this study, the effects of subhypnotic dose of propofol (1.0 mg/kg/h) alone and a combination of propofol with dexamethasone (8 mg) were compared for prevention of nausea and vomiting during cesarean delivery under spinal anesthesia. Materials and Methods: A randomized, double-blind study was carried out on 100 parturients by allocating them into two groups using computer-generated randomization method. Group I (n = 50) received intravenous (IV) saline and Group II (n = 50) received (IV) dexamethasone 8 mg respectively, followed by continuous infusion of propofol (1.0 mg/kg/h). Intraoperative emetic episodes were observed, and safety assessments were performed by an investigator, and propofol infusion was stopped at the end of surgery. Chi-square test and independent Student's t-test were used for statistical analysis wherever appropriate and P < 0.05 was considered significant. Results: The maternal demographics and operative management were comparable in the two groups. The incidence of nausea, retching, and vomiting in the intraoperative, postdelivery period were: Group I: Versus Group II: Nausea 26% (13/50) versus 8% (4/50) P = 0.014; retching 24% (12/50) versus 4% (2/50) P = 0.004; vomiting 20% (10/50) versus 4% (2/50) P = 0.014, respectively. No clinically significant adverse events were observed in both groups.Conclusion: The sub hypnotic-dose propofol 1 mg/kg/h combined with dexamethasone 8 mg was more effective than propofol alone for reducing the incidence of intraoperative emetic symptoms in parturient undergoing cesarean delivery under spinal anesthesia.