hemabate and Nausea

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