A Comparative Review between Propofol and Propofol plus Dexamethasone as Antiemetic During Cesarean Section under Spinal Anesthesia

Document Type : Original Research Papers

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anesthesia and Intensive care Dept., Faculty of Medicine, Benha University

Abstract

Background: Intraoperative nausea and vomiting (IONV) after caesarean section under spinal anaesthesia is a prevalent problem that might compromise patient safety and comfort. IONV must be effectively managed to optimise maternal and neonatal outcomes. Objectives: This study is to examine the most recent information regarding the management of intra-operative nausea and vomiting after Cesarean section under spinal anaesthesia using a combination of propofol and dexamethasone. Conclusions: Propofol plus dexamethasone can be considered as a preferred antiemetic strategy for cesarean section under spinal anesthesia. It offers superior efficacy in reducing IONV, which contributes to improved patient satisfaction. However, individual patient factors, contraindications, and known risks associated with dexamethasone should be taken into consideration.
Keywords: Cesarean Section; Spinal Anesthesia; Intraoperative Nausea and Vomiting; Propofol; Dexamethasone; Antiemetic Strategy.

1. Introduction
Neuraxial anesthesia, such as spinal anesthesia, is the preferred choice for cesarean section procedures due to its advantages over general anesthesia. General anesthesia carries risks associated with airway complications, aspiration, and increased uterine atony resulting in higher blood loss [1]. In recent years, cesarean section with spinal anesthesia has gained significant attention and has become a widely adopted surgical practice. However, a common issue encountered during cesarean section under spinal anesthesia is the occurrence of intra and postoperative nausea and vomiting (IONV and PONV). These symptoms can manifest during or after birth, impacting the well-being of both the mother and the newborn. PONV, in particular, can lead to serious complications such as airway obstruction, aspiration pneumonia, and wound dehiscence [2].

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