Effect of flurbiprofen, metoclopramide and droperidol for nausea and emesis during cesarean section under spinal anesthesia.

PURPOSE: Nausea and emesis frequently arise during cesarean section performed under spinal or epidural anesthesia, particularly after delivery. We have evaluated the treatment effects of flurbiprofen, metoclopramide and droperidol on nausea and emesis during cesarean section in patients under combined spinal and epidural anesthesia.

METHODS: The patient cohort comprised 361 patients with American Society of Anesthesiologists (ASA) physical status I or II who elected to undergo cesarean section. All patients received combined spinal-epidural anesthesia. After delivery, nausea and emesis was assessed using a 4-point scale as: 1, excellent, with no complaints; 2, mild nausea; 3, severe nausea; 4, emesis. Patients who experienced severe nausea or emesis were randomly assigned to receive one of the following intravenous drugs: Group A, flurbiprofen (50 mg); Group B, metoclopramide (10 mg); Group C, droperidol (1.25 mg). Effects on nausea and emesis were assessed at 5, 10 and 15 min after drug administration using a 4-point scale as: 1, obviously improved; 2, improved; 3, unchanged; 4 worsened.

RESULTS: Among the patients, 151 reported nausea or emesis. These patients experienced a longer duration of surgery and anesthesia and lost more blood than patients with no complaints. The frequency of improvement in the flurbiprofen group was significantly higher than that in the metoclopramide group at 5, 10 and 15 min (p < 0.05) after administration, and of that in the droperidol group at 15 min after administration (p < 0.05).

CONCLUSION: Intravenous flurbiprofen improves nausea and emesis after delivery by cesarean section more effectively than metoclopramide or droperidol.