carboprost and Nausea

Carboprost plays an important role in managing refractory uterine atony and severe postpartum hemorrhage. However, it is associated with challenging adverse reactions. We aimed to evaluate the clinical effects of low dose sufentanil on the prevention of adverse events associated with carboprost during cesarean delivery.. Patients were randomly divided into two groups: a placebo control group (group C, n = 15) that received an intravenous infusion of 1 mL of normal saline 2 min before carboprost and a sufentanil group (group S, n = 15) that received 5 μg of sufentanil. The primary outcome was the incidence of nausea and vomiting following carboprost administration.. The incidence of nausea, vomiting, and gastrointestinal discomfort was significantly lower in group S than in group C (p < 0.05).. The prophylactic use of low dose sufentanil reduces the incidence of gastrointestinal side effects caused by carboprost administration during cesarean section.

Topics: Anesthesia, Epidural; Anesthesia, Spinal; Carboprost; Cesarean Section; Double-Blind Method; Female; Humans; Nausea; Pregnancy; Sufentanil; Vomiting

We evaluated the efficacy of electroacupuncture combined with tropisetron in treating carboprost tromethamine-induced nausea and vomiting during cesarean section under lumbar anesthesia.. A total of 264 patients aged 22-40 years were enrolled, who received carboprost tromethamine and suffered nausea and vomiting during cesarean section under lumbar anesthesia. The patients were divided randomly into the control group, electroacupuncture group, tropisetron group, and electroacupuncture + tropisetron group.. Compared to the control group, the nausea and vomiting scores decreased at T3 in both the electroacupuncture and electroacupuncture + tropisetron groups, and decreased at T4 in the electroacupuncture group, tropisetron group, and electroacupuncture + tropisetron group; the motilin, gastrin, and 5-hydroxytryptamine (5-HT) levels decreased at T5 in the other 3 groups. Compared to the electroacupuncture + tropisetron group, the nausea and vomiting scores increased at T3 in the control and tropisetron groups, and increased at T4 in the other 3 groups; the motilin, gastrin, and 5-HT levels increased at T5.. Our study suggested that electroacupuncture combined with tropisetron could effectively relieve carboprost tromethamine-induced nausea and vomiting during cesarean section under lumbar anesthesia. The effect was better than its single application, and the reduced 5-HT, motilin, and gastrin levels might be involved in the underlying mechanism.. Ziel: Wir untersuchten die Wirksamkeit der Elektroakupunktur in Kombination mit Tropisetron bei der Behandlung von Carboprost-Tromethamin-induzierter Übelkeit und Erbrechen während eines Kaiserschnitts in Spinalanästhesie. Methoden: Insgesamt wurden 264 Patientinnen im Alter von 22 bis 40 Jahren, die Carboprost-Tromethamin erhalten hatten und während eines Kaiserschnitts in Spinalanästhesie an Übelkeit und Erbrechen litten, in die Studie aufgenommen. Die Patientinnen wurden randomisiert der Kontrollgruppe, der Elektroakupunktur-Gruppe, der Tropisetron-Gruppe oder der Elektroakupunktur + Tropisetron-Gruppe zugewiesen. Ergebnisse: Im Vergleich zur Kontrollgruppe sanken die Werte für Übelkeit und Erbrechen bei T3 sowohl in der Elektro­akupunktur- als auch in der Elektroakupunktur + Tropisetron-Gruppe und bei T4 in der Elektroakupunkturgruppe, in der Tropisetron-Gruppe und in der Elektroakupunktur + Tropisetron-Gruppe; die Motilin-, Gastrin- und 5-Hydroxytryptamin (5-HT)-Spiegel gingen bei T5 in den anderen drei Gruppen zurück. Im Vergleich zur Elektro­akupunktur + Tropisetron-Gruppe stiegen die Werte für Übelkeit und Erbrechen bei T3 in der Kontroll- und Tropisetron-Gruppe und stiegen bei T4 in den anderen drei Gruppen; die Motilin-, Gastrin- und 5-HT-Konzentrationen stiegen bei T5. Schlussfolgerungen: Unsere Studie spricht dafür, dass Elektroakupunktur in Kombination mit Tropisetron Carboprost-Tromethamin-induzierte Übelkeit und Erbrechen während eines Kaiserschnitts in Spinalanästhesie lindern kann. Der Effekt war stärker ausgeprägt als die alleinige Anwendung, und möglicherweise sind die verringerten 5-HT-, Motilin- und Gastrin-Konzentrationen an dem zugrunde liegenden Mechanismus beteiligt.

Topics: Antiemetics; Carboprost; Cesarean Section; Double-Blind Method; Drug Combinations; Electroacupuncture; Female; Humans; Indoles; Nausea; Pregnancy; Tromethamine; Tropisetron; Vomiting

In a prospective, open-label, assessor-blind, randomised parallel group study the efficacy and safety of Hemabate (Pharmacia-Upjohn Pharmaceuticals, Milton Keynes, Buckinghamshire) an analogue of 15-methyl-prostaglandin (PGF2alpha) analogue was compared with Syntometrine (Alliance Pharmaceuticals, Chippenham, Wilts) the standard combination of ergometrine and syntocinon used for the active management of the third stage of labour and the prevention of primary postpartum haemorrhage (PPH). The study was set in a district general hospital with approximately 4,000 deliveries annually. The study was discontinued at the time of the interim analysis because of unacceptable gastrointestinal side effects. At the time of the interim analysis, a total of 529 women had completed the study with 263 randomised to receive PGF2alpha and 266 to receive ergometrine and syntocinon. In a pre-specified subgroup analysis, women delivered vaginally were further subdivided into those considered to be at high or low risk of primary PPH. The measured blood loss and incidence of PPH was similar in both treatment groups whether delivered by caesarean section or vaginally independent of whether women were considered to be at high or low risk. Adverse gastrointestinal events were recorded more often in the Hemabate group. The most common symptom was diarrhoea which occurred in 21% of women who received Hemabate compared to only 0.8% of Syntometrine users. PGF2alpha is as effective as Syntometrine in the prophylaxis of primary PPH in all groups studied but there was a statistically significantly increased risk of diarrhoea among users of PGF2alpha.

Topics: Adult; Blood Pressure; Body Height; Body Weight; Carboprost; Cesarean Section; Dinoprost; Disease Susceptibility; Drug Combinations; Ergonovine; Female; Gastrointestinal Diseases; Humans; Nausea; Oxytocin; Parity; Postpartum Hemorrhage; Pregnancy; Random Allocation; Single-Blind Method; Tromethamine

To evaluate whether a double prostaglandin impact enhances the effectiveness of the 15S-15-methyl prostaglandin (PG) F2 alpha methyl ester analogue in 1st and 2nd trimester abortion, 2 vaginal suppositories spaced 3 hours apart were administered to 10 patients. The patients' ranged from 19-39 years; length of gestation ranged from 44-56 weeks. Uterine contraceptions began from 40-190 minutes after suppository insertion, and bleeding was seen within 120-610 minutes. 3 of the 10 subjects expelled products of conception during the 10-hour observation period. All subjects reported persistent vaginal bleeding after the procedure, and in 8 subjects the bleeding continued for 14 or more days. 6 subjects reported repeated nausea and vomiting, and 7 experienced diarrhea. Both plasma progesterone values and human chorionic gonadotropin (hCG) beta-subunit levels declined during the 10-hour observation period. The significant drop in beta-subunit hCG levels noted at the follow-up visit indicated 8 of the pregnancies had been successfully interruped showed a drop in plasma progesterone levels, showing that this measure does not predict outcome. Overall, the results in this small series do not suggest any improvement in efficacy over that reported with a single vaginal suppository. The frequency and severity of gastrointestinal side effects appeared to be greater and vaginal bleeding was more porlonged. In addition, uterine contractions began earlier and were more intense, requiring greater use of analgesic medication. It is possible, however, that more applications of smaller dosages given at shorter intervals could improve efficacy and reduce the frequency and severity of side effects.

Topics: Abortion, Induced; Adult; Carboprost; Chorionic Gonadotropin; Diarrhea; Female; Humans; Nausea; Pregnancy; Prostaglandins F, Synthetic; Suppositories; Uterine Hemorrhage