الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Intra- and postoperative nausea and vomiting (IONV &PONV) accompanying caesarean section are prevalent and unpleasant events that impair surgical conditions for the gynaecologist and the anesthesiologist, reaching incidences up to 80% and increasing the likelihood of wound dehiscence, postoperative aspiration of gastric contents and electrolyte imbalance. Also, they can prolong postoperative hospital stays that significantly increase the overall health care costs.
Many factors participate in the emergence of N&V in CS under neuraxial anaesthesia, including the obstetric risk factors (female gender, young age, non-smoker, physiological changes of pregnancy), spinal induced hypotension, which is one of the most important etiological factors for nausea and vomiting affecting approximately 90% of the obstetric population, vagal hyperactivity stimulated by exteriorization of the uterus during surgery, visceral pain, i.v. opioid supplementation and uterotonic agents.
Controlling these aetiological factors and the prophylactic use of antiemetics can reduce the incidence of N&V.
Plenty of antiemetic drugs are available these days, of which 5HT3 receptor antagonists (ondansetron, granisetron, dolasetron) and steroids (dexamethasone) are used.
The present study aimed to compare the effect of ondansetron, dexamethasone, and the combination of both drugs on nausea and vomiting in CS under spinal anaesthesia, as well as parturients’ satisfaction and occurrence of complications.
The current study was carried out on 108 adult female parturients aged 18 to 35 years old, admitted to EL Shatby Hospital, scheduled for elective caesarean section under spinal anaesthesia, and were selected according to the American Society Of Anesthesiologists (ASA) I or II.
Parturients were excluded from the study upon pre-eclampsia or eclampsia, gastrointestinal disorder or motion sickness, twin pregnancy, any known contraindication for spinal anaesthesia, and history of sensitivity to used drugs.
Parturients were randomly allocated into three equal groups using the closed envelope method of randomization (36 parturients each).
group I (O)
Parturients were given 2.5 ml (12.5 mg) of 0.5% hyperbaric bupivacaine intrathecally for a spinal block and then intravenous 4 mg of ondansetron 2 minutes after cord clamping.
group II (D)
Parturients were given 2.5 ml (12.5 mg) of 0.5% hyperbaric bupivacaine intrathecally for a spinal block and then intravenous 8 mg of dexamethasone 2 minutes after cord clamping.