Prevalence of Nausea and Vomiting and the Related Factors during Cesarean Section under Spinal Anesthesia

Nausea and vomiting during cesarean section are common under spinal anesthesia. The aim of the present study was to investigate the prevalence of nausea and vomiting and the related factors during elective cesarean under spinal anesthesia.

A descriptive study was performed on 200 pregnant women who were candidates for elective cesarean section under spinal anesthesia in Taleghani Hospital between 2017-2018. For each participant, age, number of pregnancies, number of deliveries, history of previous cesarean section, nausea and vomiting in previous cesarean section(s), smoking during pregnancy, nausea and vomiting during the first trimester of pregnancy, premenstrual syndrome, and motion sickness were asked and  BMI, duration of operation, the highest level of blocked dermatome, baseline pulse rate, and systolic pressure decreased by more than 20%, the incidence of nausea and severity, or vomiting during surgery, and the sex of the infant were recorded. Data were fed into SPSS column, version 21, and analyzed using descriptive statistics and independent t, Mann-Whitney, Chi-square, and Fisher exact tests. P-values less than 0.05 were considered significant. 

The prevalence of nausea and vomiting were 58% and 16%, respectively. The history of nausea and vomiting in the first trimester of pregnancy, pregnancy with the female fetus, and systolic pressure decreased by more than 20% in both groups of patients with nausea (P< 0.001) and vomiting (P<0.001) during cesarean section under spinal anesthesia were more prevalent than those without nausea and vomiting. Also, the prevalence of motion sickness (P <0.047) and history of nausea and vomiting during the previous cesarean section were significantly different in the non-nauseous group after spinal anesthesia (P <0.004) in patients with nausea during surgery. The highest level of blocked dermatome was significantly different in both groups with and without vomiting (p <0.001).

The currrent study showed once more that nausea and vomiting were common during cesarean section under spinal anesthesia. It seems that checking some factors in the medical history of a person may help in predicting this complication.