Intravenous Granisetron Combined with Dexamethasone in Cesarean Section Patients Undergoing Spinal Anesthesia

Syafruddin Gaus; Irfan Faisal 	 Sjattar; Andi  Salahuddin; Muhammad Ramli  Ahmad; Nur Surya	 Wirawan; Arifin	 Seweng

doi:10.3889/oamjms.2023.10848

Authors

Syafruddin Gaus Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Hasanuddin University, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Irfan Faisal Sjattar Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Hasanuddin University, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Andi Salahuddin Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Hasanuddin University, Daya Hospital, Makassar, Indonesia
Muhammad Ramli Ahmad Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Hasanuddin University, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Nur Surya Wirawan Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Hasanuddin University, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Arifin Seweng Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Hasanuddin University, Siloam Hospital, Makassar, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2023.10848

Keywords:

caesarean section, shivering, spinal anesthesia, nausea, vomiting

Abstract

BACKGROUND: Regional anesthesia, including spinal anesthesia, is the technique-of-choice over general anesthesia for cesarean section (C-section). Nausea, vomiting, and shivering are common after spinal anesthesia. Granisetron and dexamethasone are used as a premedication to prevent these reactions.

AIM: This study determined the effect of different doses of granisetron combined with dexamethasone for the prevention of nausea, vomiting, and shivering.

PATIENTS AND METHODS: This double-blind randomized clinical trial included patients undergoing C-section under spinal anesthesia at several hospitals in Makassar, Indonesia. Forty-five cases were divided into three equal-sized groups: G5, administered intravenous (IV) granisetron at 5 mcg/kg body weight (BW); G10, administered IV granisetron at 10 mcg/kgBW; and G25, administered IV granisetron at 25 mcg/kgBW. All patients also received IV dexamethasone at 0.1 mg/kgBW.

RESULTS: In the G10 group, three cases experienced mild nausea, while, in the G5 and G25 groups, there were no incidences of nausea; this was a statistically significant difference (p = 0.043). Vomiting was not reported in any group. The G25 group had the lowest number of patients experiencing shivering (one case with a score of 3), but there were no significant differences in shivering incidence between groups (p = 0.164).

CONCLUSION: Granisetron is effective in reducing nausea and shivering at certain dosage.

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