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Continuous Infusion of Sub-hypnotic Dose Propofol Reduces Carboprost-induced Nausea and Vomiting during Caesarean Delivery: A Prospective, Randomized, Double-blinded, placebo-controlled Trial
Abstract Number: T4A-1
Abstract Type: Original Research
Background. Carboprost, one of the most effective treatment options to reduce postpartum haemorrhage by causing uterine contraction, has been well identified as a risk factor for nausea and vomiting during caesarean delivery (CD). The aim of this prospective, randomized, double-blinded, placebo-controlled clinical study was to evaluate whether propofol, infused at sub-hypnotic dose, can reduce nausea and vomiting after administration of carboprost in patients undergoing CD.
Methods. Sixty parturients were randomly allocated to receive propofol or saline infusion (n=30 per group), immediately after carboprost administration during CD under spinal anaesthesia. Propofol was first given at the loading dose of 0.3 mg/kg, followed by continuous infusion at the rate of 1.0 mg/kg/hrs. The primary outcome was incidence of intra-operative nausea and vomiting (including fetching and vomiting). Using of granisetron as a rescuing agent for vomiting, Bispectral Index (BIS) value following propofol/saline infusion, incidence of post-operative nausea and vomiting and patient-reported discomforts were also recorded.
Results. As showed in Figure 1, the incidence of intra-operative nausea and vomiting was significantly lower in patients receiving propofol (76.67% vs 46.67%, Odds Ratio (OR) [95% Confidential Interval (CI)] = 0.27 [0.092 to 0.78], p = 0.0163). The use of granisetron was significantly reduced by propofol infusion (76.67% vs 30.00%, OR [95% CI] = 0.13 [0.040 to 0.41], p=0.0003). There was also less patient-reported discomforts, such as dizziness, chest congestion and flushing, in patients receiving propofol. All the patients receiving propofol were kept awake and there was no difference in BIS between the two groups.
Conclusion. Sub-hypnotic dose of propofol reduces the incidence of carboprost-induced nausea and vomiting during caesarean delivery, with minimal effect on patients' conscious state.