carboprost and Vomiting

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

To observe the effect and safety of hemabat (H) on prevention of postpartum hemorrhage in cesarean section and after cesarean section in high risk pregnant women.. Four hundred and sixty-nine pregnant women with high hemorrhagic risk factors including twin pregnancy, polyhydramnios, fetal macrosomia, placenta previa were planned cesarean section. A total of 457 pregnant women were divided into 3 groups by operation indications. There were 239 cases of fetal macrosomia, 145 cases of twin pregnancy and polyhydramnios, and 73 cases of placenta previa. Three kinds of hysterotonics were used randomly in each group. Group oxytocin (O): 20 U oxytocin injected into the uterine plus 20 U oxytocin intravascularly, 152 women; Group oxytocin + hemabate (O + H): 20 U oxytocin and 250 microg hemabat injected into the uterine, 192 women; group H: 250 microg hemabat, injected into the uterine, 125 women. The amount of bleeding during the operation and within 2-hour after delivery were measured. The side effect of each group was observed.. The amount of bleeding during cesarean section in group O was (445 +/- 262) ml, in group O + H (332 +/- 218) ml, and in group H (375 +/- 265) ml. There was an extremely significant difference between group O and group O + H (P < 0.01). The amount of bleeding within 2 hours after delivery in group O was (176 +/- 193) ml, in group O + H was (110 +/- 114) ml, and in group H was (124 +/- 103) ml. There was a significant difference between groups O, O + H and H. Among the 469 women, 31 had total amount of bleeding more than 1000 ml during operation and within 2 hours after delivery. 48% (15 women) were in group O, 23% in group O + H and 29% in group H. The total amount of bleeding in group O was much more than group O + H and group H in the group of fetal macrosomia (P < 0.01, P < 0.01). Similar results were found in the group of twin pregnancy and polyhydramnios (P < 0.01, P < 0.01). The total amount bleeding in group O + H was much less than group O in the group of placenta previa (P < 0.05). There were 5% (12) pregnant women whose total amount of bleeding was >/= 1000 ml in the group of fetal macrosomia, 8% (11) in the group of twin pregnancy, 11% (8) in the group of placenta previa. No hysterectomy was done among the women. The incidence of side effects in the three groups was 2.6%, 11.5% and 7.0% respectively. Vomiting was frequently seen in the latter two groups, but recovered soon without treatment.. Hemabat can significantly reduce the amount of bleeding during the cesarean section in pregnant women with high hemorrhagic risk factors and can be used with oxytocin as firstline medicine to prevent hemorrhage during and after delivery.

Topics: Adult; Carboprost; Cesarean Section; Female; Humans; Oxytocin; Postoperative Hemorrhage; Postpartum Hemorrhage; Pregnancy; Prospective Studies; Risk Factors; Treatment Outcome; Uterus; Vomiting

The use of intramuscular (15S)-15-methyl prostaglandin F2 alpha (Prostin/15 M [The Upjohn Company, Kalamazoo, Michigan] sterile solution; carboprost tromethamine) for termination of pregnancy between six and 24 weeks' gestation was studied by 20 investigators. Of 815 women treated according to the dosage regimen described here, 78.4% had complete abortions and 18.0% incomplete abortions, for an overall success rate of 96.4%. The majority of patients had vomiting and diarrhea but usually tolerated these side effects well enough that treatment did not have to be discontinued. There were no serious adverse reactions directly attributable to the prostaglandin therapy.

Topics: Abortion, Induced; Adolescent; Adult; Carboprost; Child; Clinical Trials as Topic; Female; Humans; Injections, Intramuscular; Parity; Pregnancy; Prostaglandins F, Synthetic; Time Factors; Vomiting

A new approach to terminate very early pregnancy was tried on 49 healthy women who were proven to be pregnant from 31 to 47 days from their last menstrual period. All pregnancies were confirmed either by UCG or serum HCG-B subunit. (15S)-15-Methyl PGF2 alpha Methyl Ester in a suppository form was administered in two separate doses: 1.0 mg initial dose followed by 3.0 mg one hour later. Patients were kept under observation for 8 hours. Blood sampling for progesterone, HCG-B, and prostaglandin levels were assayed at 0 degree, 30', 1 degree, 4 degrees, 8 degrees and 14 days. Patients were re-examined at a two week follow-up visit. Pelvic examination and pregnancy tests were performed to confirm whether the pregnancy was successfully terminated. There were no significant changes in serums progesterone and HCG-B levels during the 8-hour observation period. Both levels declined significantly to very low levels at 14 days post-therapy, confirming the clinical impression of successful termination of pregnancy. Plasma prostaglandin levels rose as early as 30 minutes after initiation of therapy, peaked at 4 hours and declined gradually afterwards. Most side effects such as nausea, vomiting, diarrhea and cramps, although clinically manageable, were still bothersome. One patient experienced an episode of vasovagal syncope. The majority of patients required medical observation up to 6 hours. Clinical implications of this new approach of termination of very early pregnancy are discussed.

Topics: Abortion, Induced; Adolescent; Adult; Carboprost; Chorionic Gonadotropin; Chorionic Gonadotropin, beta Subunit, Human; Diarrhea; Female; Humans; Peptide Fragments; Pregnancy; Progesterone; Prostaglandins F, Synthetic; Suppositories; Uterine Contraction; Vagina; Vomiting