The efficacy of ginger in prevention of postoperative nausea and vomiting after intrathecal morphine for lower extremity surgery

Abstract

Objective: To compare the efficacy of ginger administered preoperatively in prevention of postoperative nausea and vomiting (PONV) after intrathecal morphine for lower extremity surgery. Design: Randomized double-blind controlled trial Setting: Bangkok Metropolitan Administration General hospital Method: One hundred and eight patients who scheduled for lower extremity surgery under spinal anesthesia with intrathecal morphine were randomly allocated into 2 groups by simple randomization. Groupl received 1 g of ginger and Group 2 received placebo orally 1 hour before induction of anesthesia in a double-blind fashion. Outcome variables included incidence of PONV, severity of nausea, requirement of anti-emetic, pain intensity, pruritus score and any adverse effect. Results: The incidence of PONV were 38.9% in ginger group and 61.1% in placebo group. The result was considered statistically significant (p-value = 0.021) by Z test. Absolute risk reduction (ARR) for PONV by premedication with ginger was 22%, with 95% confidence interval from 3.6% to 40.4% The number needed to treat was 5, with 95% confidence interval from 2 to 28. Ginger group also had less severity of nausea than placebo (p-value = 0.033). However, there was no statistically significant difference between two groups regarding requirement of anti-emetic, time to first rescue anti-emetic, emetic episode per patient, pruritus score, requirement of anti-pruritus, pain intensity, and requirement of analgesic. There were seven patients who had urinary retention; one in ginger group and six in placebo group. No any other side effect was detected. Conclusion: Ginger was more efficacious than placebo in prevention postoperative nausea and vomiting after intrathecal morphine for lower extremity surgery.