hedyeh rezaei

Nausea and vomiting during spinal anesthesia for elective cesarean delivery is a common finding and may occur in up to 80% of patients. The aim of the present study was to compare efficacy of using intravenous midazolam alone, ondansetron, and midazolam in combination with ondansetron for prevention of nausea and vomiting during and after cesarean delivery in parturient that underwent spinal anesthesia.
In a double-blind study, 126 women undergoing elective caesarean section under spinal anesthesia (using 0.5% bupivacaine 12.5 mg) were allocated randomly to receive midazolam 2 mg (n=42), ondansetron 4 mg (n=42) or midazolam and ondansetron (n=42) after the clamping umbilical cord. The frequency of nausea and vomiting during and after surgery in recovery room were recorded.
The frequency of intraoperative nausea and vomiting was lower in the O (28.6, 7.1%) and MO (26.2, 16.7%) groups compared with M (50, 31%) group (P=0.04, P=0.006). The frequency of nausea and vomiting after surgery in recovery room was lower in the O (4.8, 19 %) and MO (11.9, 7.1%) groups compared with M(38.1, 23,8 %) group (P=0.01, P=0.03). Metoclopramide consumption was lower in O and MO groups compared with M group (P=0.02). There was no difference in mean arterial pressure and pulse rate between three groups during the surgery at times measured.
A bolus dose of midazolam (2 mg) was not effective than ondansetron (4mg) and ondansetron plus midazolam (O 4 and M 2 mg) for the prevention of nausea and vomiting in parturient patients undergoing cesarean section with spinal anesthesia during and after surgery in recovery room; however, further studies are needed.

In general anesthesia, patients’ coughing during and after recovery is an important clinical problem with a prevalence of 15% to 45%. This study aimed to evaluate the effects of alkalinized lidocaine or lidocaine alone into the tracheal tube cuff on post-extubation cough in lumbar laminectomy surgery with general anesthesia.
Ninety patients scheduled for lumbar laminectomy in prone position were enrolled in this randomized double-blind prospective study. After tracheal intubation, the tracheal tube cuff was filled with either an alkalinized 2% lidocaine solution or lidocaine alone or 0.9% saline. A logistic regression comprising the two factors was used for analysis. The incidence of sore throat reported by patients and cough 0, 10 and 30 minutes at recovery after extubation.
Intracuff alkalinized 2% lidocaine was superior to lidocaine alone and saline in blunting emergence coughing 10 and 30 minutes at recovery after extubation (P = 0.035- P= 0.005). The incidence of sore throat was significantly lower in the alkalinized 2% lidocaine group at the recovery at 10 and 30 min after extubation(p = 0.001).
The present study showed that the intracuff alkalinized 2% lidocaine was superior to lidocaine alone or saline in decreasing the incidence of emergence coughing and sore throat during the recovery room after extubation.