Volume 14, Issue 4 (3-2025)
Clin Exc 2025, 14(4): 30-40 |
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Shabankhani K, Sobhani S. Treatment-Resistant Nausea and Vomiting after Spinal Anesthesia in Cesarean Delivery: A Clinical Challenge. Clin Exc 2025; 14 (4) :30-40
URL: http://ce.mazums.ac.ir/article-1-888-en.html
URL: http://ce.mazums.ac.ir/article-1-888-en.html
Assistant Professor of Anesthesia, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.
Abstract: (237 Views)
Spinal Anesthesia-Induced Nausea and Vomiting is one of the most common and unpleasant complications in pregnant women undergoing cesarean section. This complication is reported with a prevalence of about 60%-80% and has complex causes. A major cause of nausea and vomiting is the decrease in blood pressure brought on by anesthesia-induced peripheral blood vessel dilatation and the impact of pregnancy hormones, such as progesterone and estrogen. There are different preventive and therapeutic measures to manage this complication. Among these measures are the use of intravenous fluids before anesthesia to prevent hypotension, and the injection of vasopressor drugs, such as ephedrine or phenylephrine, in case of pressure drop. Anti-nausea drugs, such as ondansetron and metoclopramide, also help to reduce the severity of nausea.
In this case study, a 43-year-old pregnant woman with a gestational age of 37 weeks and 5 days and without any history of nausea and vomiting during pregnancy experienced severe nausea and vomiting after spinal anesthesia. The patient's nausea and vomiting were without a drop in blood pressure and heart rate. Despite taking all preventive and therapeutic measures, such as fluid therapy, administration of ondansetron, metoclopramide, and propofol, as well as proper positioning, the patient's nausea and vomiting did not improve. The patient's symptoms finally improved after the end of the operation, and she was transferred to the ward after 12 hours. It seems that this complication is caused by the direct exposure of the chemical receptor-stimulating areas in the brain with the anesthetic agent. Therefore, more research should be considered about the prevalence of this condition and the effective factors in its recovery or exacerbation.
In this case study, a 43-year-old pregnant woman with a gestational age of 37 weeks and 5 days and without any history of nausea and vomiting during pregnancy experienced severe nausea and vomiting after spinal anesthesia. The patient's nausea and vomiting were without a drop in blood pressure and heart rate. Despite taking all preventive and therapeutic measures, such as fluid therapy, administration of ondansetron, metoclopramide, and propofol, as well as proper positioning, the patient's nausea and vomiting did not improve. The patient's symptoms finally improved after the end of the operation, and she was transferred to the ward after 12 hours. It seems that this complication is caused by the direct exposure of the chemical receptor-stimulating areas in the brain with the anesthetic agent. Therefore, more research should be considered about the prevalence of this condition and the effective factors in its recovery or exacerbation.
Type of Study: case report |
Subject:
بیهوشی
Received: 2024/11/10 | Accepted: 2025/03/28 | Published: 2025/03/28
Received: 2024/11/10 | Accepted: 2025/03/28 | Published: 2025/03/28
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