A recent study published in the “Egyptian Journal of Anaesthesia” compared two medications for preventing nausea and vomiting during cesarean deliveries performed under spinal anesthesia. The trial pitted Hyoscine butyl-bromide (HBB) against Ondansetron, two drugs known for their anti-nausea properties.

In women who were scheduled to undergo a cesarean section with spinal anesthesia, the use of prophylactic HBB was found to be equally effective as Ondansetron in minimizing intraoperative vomiting. Additionally, HBB had the advantage of causing a lower occurrence of intraoperative bradycardia compared to Ondansetron. On the other hand, Ondansetron remarkably reduced postoperative nausea and vomiting (PONV) occurrence.

Mostafa Samy Abbas et al. performed this randomized, double-blind, placebo-controlled trial, which included 55 participants undergoing elective caesarean delivery. They were assigned to receive either intravenous HBB (20 mg), Ondansetron (8 mg), or a saline placebo (0.9%) just before spinal anaesthesia. The key endpoint of the study was to determine the occurrence of intraoperative nausea and vomiting (IONV). Secondary objectives included examining instances of maternal bradycardia and hypotension during surgery, as well as assessing PONV.

Below are the major findings of the study:

• Reduced Intraoperative Emesis with HBB: HBB was found to reduce the incidence of emesis during the surgical procedure when compared to the control group. This is an encouraging outcome for expectant mothers undergoing cesarean deliveries.
• Ondansetron's Impact on IONV: Ondansetron statistically decreased the incidence of IONV and was found to be effective when compared to the control group (P = 0.034).
• HBB Addresses Bradycardia (slow heart rate): HBB considerably reduced the incidence of intraoperative maternal bradycardia when compared to the control group (1.8% vs. 14.5%). This finding is particularly important as it enhances the safety of the procedure (OR = 0.1, 95% CI = [0.01, 0.90]; P < 0.039).
• Ondansetron's Superiority in the Postoperative Phase: In the postoperative period, Ondansetron outperformed HBB in reducing PONV compared to the control group.

These findings mark a huge leap in improving the experience of expectant mothers undergoing cesarean deliveries. The study's insights into the efficacy and safety of these medications hold promising outcomes for maternal care during childbirth.