Dexamethasone for the Prevention of Post-operative Nausea and Vomiting in Patients Undergoing Cesarean Sections
| Status: | Completed |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | 18 - 40 |
| Updated: | 4/2/2016 |
| Start Date: | November 2012 |
| End Date: | December 2013 |
| Contact: | Klaus Kjaer, MD |
| Email: | klk9001@med.cornell.edu |
| Phone: | 212-746-2781 |
A Prospective, Randomized, Double-Blinded Study to Evaluate the Efficacy of Intravenous Dexamethasone for Nausea Prophylaxis Prior to Duramorph and Bupivacaine Spinal Anesthesia for Scheduled Cesarean Section
Women having cesarean sections commonly experience post-operative nausea and vomiting
(PONV). This can be partly attributed to the long acting morphine (duramorph) given in the
anesthetic (either through the epidural or in the spinal anesthetic). Intravenous
dexamethasone is a widely used steroid medication with a well-established safety profile
which is the standard of care for the prevention of PONV for general anesthesia in both
adult and pediatric surgical patients. Many studies have shown that when intravenous
dexamethasone is administered before duramorph in the epidural, the incidence of nausea and
vomiting following cesarean section is significantly reduced. However, when patients receive
intravenous dexamethasone after duramorph in a spinal anesthetic, it does not reduce the
incidence of nausea and vomiting. There are not any published studies where dexamethasone
was administered before a spinal anesthetic. The investigators believe that if dexamethasone
is given intravenously before duramorph in a spinal anesthetic it may reduce the incidence
of nausea and vomiting. Patients who present for scheduled (non-emergent) cesarean section
will be given either intravenous dexamethasone or placebo prior to receiving a duramorph
containing spinal anesthetic. The investigators will then compare the incidence of nausea
and vomiting and the use of rescue anti-nausea medications in both groups. Our hypothesis is
that patients receiving dexamethasone prior to duramorph containing spinal anesthesia for
cesarean section will have a significantly lower incidence and severity of PONV at 0, 1, 3,
6, and 24 hours following surgery.
(PONV). This can be partly attributed to the long acting morphine (duramorph) given in the
anesthetic (either through the epidural or in the spinal anesthetic). Intravenous
dexamethasone is a widely used steroid medication with a well-established safety profile
which is the standard of care for the prevention of PONV for general anesthesia in both
adult and pediatric surgical patients. Many studies have shown that when intravenous
dexamethasone is administered before duramorph in the epidural, the incidence of nausea and
vomiting following cesarean section is significantly reduced. However, when patients receive
intravenous dexamethasone after duramorph in a spinal anesthetic, it does not reduce the
incidence of nausea and vomiting. There are not any published studies where dexamethasone
was administered before a spinal anesthetic. The investigators believe that if dexamethasone
is given intravenously before duramorph in a spinal anesthetic it may reduce the incidence
of nausea and vomiting. Patients who present for scheduled (non-emergent) cesarean section
will be given either intravenous dexamethasone or placebo prior to receiving a duramorph
containing spinal anesthetic. The investigators will then compare the incidence of nausea
and vomiting and the use of rescue anti-nausea medications in both groups. Our hypothesis is
that patients receiving dexamethasone prior to duramorph containing spinal anesthesia for
cesarean section will have a significantly lower incidence and severity of PONV at 0, 1, 3,
6, and 24 hours following surgery.
Inclusion Criteria:
- Women aged 18-40 presenting for scheduled primary or repeat cesarean sections and
have consented to study
Exclusion Criteria:
- allergy to dexamethasone or morphine
- history of gastrointestinal disease
- history of severe nausea during pregnancy (hyperemesis gravidarum)
- use of anti-emetic in the past 24 hours
- history of gestational diabetes or diabetes mellitus
- history of hypertension prior to or during pregnancy
- presence of non-viable fetus
We found this trial at
1
site
Click here to add this to my saved trials
