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EFFECT OF HYPOTENSION ON THE INCIDENCE OF NAUSEA AND VOMITING IN RECOVERY IN PATIENTS UNDERGOING ELECTIVE CAESAREAN SECTION UNDER SPINAL ANAESTHESIA
ESRA Academy. Gnanamuttu A. Sep 8, 2016; 138285
Topic: Obstetric Population
Dr. Anush Gnanamuttu
Dr. Anush Gnanamuttu

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Abstract
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Background and Aims:

Hypotension is an important cause of intraoperative nausea and vomiting in women undergoing caesarean section under spinal anaesthesia. Phenylephrine is used intraoperatively to prevent hypotension but generally discontinued towards the end of surgery. But the sympathetic block following spinal anaesthesia can last longer. This can cause hypotension in recovery, which can potentially lead to dizziness, nausea and vomiting.The aim of this study is to look at the association between hypotension and nausea and vomiting in recovery.

Methods:

Our study was a prospective observational study of all elective caesarean sections conducted over 3 months. We collected data on perioperative blood pressure, nausea, vomiting and dizziness.

Results:

The incidence of nausea and vomiting was 21% intraoperatively and 6.6% in recovery. The average percentage fall in blood pressure in patients in who experienced nausea and vomiting in recovery was 27% compared to17% in those who did not. All the patients who experienced nausea and vomiting in recovery had a >15% drop in systolic blood pressure

Conclusions:

This study shows that there is a clear association between hypotension and nausea and vomiting in recovery.Studies have shown that if the blood pressure was maintained at 90% of the baseline, then the incidence of intraoperative nausea and vomiting was 16% compared to 40% if it was maintained at 80%.Although patients tolerate hypotension better after delivery, in susceptible patients it can lead to nausea and vomiting. Further studies are needed to see if continuing the phenylephrine infusion in recovery would reduce the incidence of nausea and vomiting.

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