Prevention of postoperative nausea and vomiting after cesarean delivery under neuraxial anesthesia and postpartum analgesia in Japan: A cross-sectional study.

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  • Additional Information
    • Source:
      Publisher: Wiley on behalf of the Japan Society of Obstetrics and Gynecology] Country of Publication: Australia NLM ID: 9612761 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1447-0756 (Electronic) Linking ISSN: 13418076 NLM ISO Abbreviation: J Obstet Gynaecol Res Subsets: MEDLINE
    • Publication Information:
      Publication: [Melbourne, Vic. : Wiley on behalf of the Japan Society of Obstetrics and Gynecology]
      Original Publication: Tokyo : University of Tokyo Press, c1996-
    • Subject Terms:
      Cesarean Section*/adverse effects ; Postoperative Nausea and Vomiting*/prevention & control ; Postoperative Nausea and Vomiting*/epidemiology ; Postoperative Nausea and Vomiting*/etiology; Humans ; Female ; Japan ; Cross-Sectional Studies ; Pregnancy ; Adult ; Anesthesia, Obstetrical/adverse effects ; Anesthesia, Obstetrical/methods ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/therapeutic use ; Antiemetics/administration & dosage ; Antiemetics/therapeutic use ; Analgesia, Obstetrical/methods ; Analgesia, Obstetrical/statistics & numerical data
    • Abstract:
      Aims: This study aims to investigate the clinical practice of physicians working in obstetric setting toward postoperative nausea and vomiting (PONV) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia.
      Methods: We conducted this online survey to all active members of the Japan Society of Obstetric Anesthesiology and Perinatology (JSOAP), where leads academic society in obstetric anesthesia in Japan. The questionnaire was developed using the Delphi method. The survey included questions about routine practices for PONV prevention, the use of neuraxial opioids, optimal practices, and perceived obstacles. The email sent three times every 2 weeks as a reminder.
      Results: A total of 1046 e-mails were sent, and 307 JSOAP members responded to the survey (29.3%). More than half of responders (62.7%) used neuraxial opioids with intrathecal morphine being the most frequent. They had a higher rate of multimodal PONV prophylaxis compared with who did not use neuraxial opioids for postoperative analgesia (19.9% vs 6.7%). Metoclopramide was the commonest medication for PONV prevention, and there was a significant difference in the use of 5-hydroxytryptamine receptor antagonists (19.9% vs. 8.6%, p = 0.012). We observed that 80% of physicians reported the routine administration of prophylaxis for PONV for CD. Among these, 20% indicated the use of two or more agents. Conversely, in the cohort not administering neuraxial opioids, only 6.7% reported the use of two or more agents.
      Conclusion: The online survey showed that the physicians using neuraxial opioids for CD had a higher proportion of multimodal PONV management involving two or more agents.
      (© 2024 Japan Society of Obstetrics and Gynecology.)
    • References:
      Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe‐Leitz T, et al. Size and distribution of the global volume of surgery in 2012. Bull World Health Organ. 2016;94:201–209.
      Griffiths JD, Gyte GM, Popham PA, Griffiths JD, Gyte GM, Popham PA, et al. Interventions for preventing nausea and vomiting in women undergoing regional anaesthesia for caesarean section. Cochrane Database Syst Rev. 2021;5:CD007579.
      Teigen NC, Sanhasrabudhe N, Doulaveris G, Xie X, Negassa A, Bernstein J, et al. Enhanced recovery after surgery at cesarean delivery to reduce postoperative length of stay: a randomized controlled trial. Am J Obstet Gynecol. 2020;222:372.e1–372.e10.
      Bollag L, Lim G, Sultan P, Habib AS, Landau R, Zakowski M, et al. Society for Obstetric Anesthesia and Perinatology: consensus statement and recommendations for enhanced recovery after cesarean. Anesth Analg. 2021;132:1362–1377.
      Macones GA, Caughey AB, Wood SL, Wrench IJ, Huang J, Norman M, et al. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) society recommendations (part 3). Am J Obstet Gynecol. 2019;221:247.e1–247.e9.
      Balki M, Carvalho JC. Intraoperative nausea and vomiting during cesarean section under regional anesthesia. Int J Obstet Anesth. 2005;14:230–241.
      Takei D, Narita M, Shiokawa M, Yomiya K, Suzuki T. Drug therapy for nausea and vomiting. Jpn J Pharm Palliat Care Sci. 2009;2:111–117.
      Sigaut S, Eurin M, Fauquenot C, Keita H, Paugam‐Burtz C. Choice of anaesthetic agents for caesarean section under general anaesthesia: a French national survey of current practices. Int J Obstet Anesth. 2020;41:115–118.
      NICE. NICE guideline [NG192]. Caesarean birth. https://www.nice.org.uk/guidance/ng192/chapter/Recommendations#care-of-the-woman-after-caesarean-birth. Accessed 16 Aug 2023.
      Ministry of Health, Labour and Welfare. Survey of medical institutions. https://www.mhlw.go.jp/toukei/saikin/hw/iryosd/20/dl/02sisetu02.pdf (2020). Accessed 16 Aug 2023.
      Voigt M, Fröhlich CW, Hüttel C, Kranke P, Mennen J, Boessneck O, et al. Prophylaxis of intra‐ and postoperative nausea and vomiting in patients during cesarean section in spinal anesthesia. Med Sci Monit. 2013;14:993–1000.
      Wu JI, Lo Y, Chia YY, Liu K, Fong WP, Yang LC, et al. Prevention of postoperative nausea and vomiting after intrathecal morphine for cesarean section: a randomized comparison of dexamethasone, droperidol, and a combination. Int J Obstet Anesth. 2007;16:122–127.
      Cardoso MM, Leite AO, Santos EA, Gozzani JL, Mathias LA. Effect of dexamethasone on prevention of postoperative nausea, vomiting and pain after caesarean section. Eur J Anaesthesiol. 2013;30:102–105.
      Harnett MJ, O'Rourke N, Walsh M, Carabuena JM, Segal S. Transdermal scopolamine for prevention of intrathecal morphine‐induced nausea and vomiting after cesarean delivery. Anesth Analg. 2007;105:764–769.
      Oji‐Zurmeyer J, Ortner CM, Klein KU, Gries M, Kühn C, Schroffenegger T, et al. National survey of obstetric anaesthesia clinical practices in the Republic of Austria. Int J Obstet Anesth. 2019;39:95–98.
      Yonekura H, Mazda Y, Noguchi S, Tsunobuchi H, Shimaoka M. Trend in neuraxial morphine use and postoperative analgesia after cesarean delivery in Japan from 2005 to 2020. Sci Rep. 2022;12:17234.
    • Grant Information:
      23K15585 Grant-in-Aid for Early-Career Scientists
    • Contributed Indexing:
      Keywords: cesarean delivery; postoperative nausea and vomiting; postpartum analgesia
    • Accession Number:
      0 (Analgesics, Opioid)
      0 (Antiemetics)
    • Publication Date:
      Date Created: 20240917 Date Completed: 20241003 Latest Revision: 20241003
    • Publication Date:
      20241003
    • Accession Number:
      10.1111/jog.16087
    • Accession Number:
      39287012