Background: The antiemetic efficacy of metoclopramide and midazolam was shown before. The aim of the present study was to compare the efficacy and safety using intravenous metoclopramide and intrathecal midazolam for the prevention of nausea­vomiting in parturient undergoing cesarean section under spinal anesthesia. Methods: This prospective and randomized double blind study was conducted in 100 parturient aged between 21 and 30 years, ASA physical status É, scheduled to undergo elective cesarean section under spinal anesthesia. Parturient presenting for cesarean section with standardized 0.5% hyperbaric bupivacaine 2 ml spinal anesthesia were randomized to intravenous metoclopramide 10 mg (group I) or intrathecal midazolam 2mg ( group II). The incidence of nausea­vomiting and any other adverse effect were recorded during intraoperative and early postoperative period and compared between two groups by using chi­square test. Results: The incidence of nauseavomiting was 36% with intravenous metoclopramide and 10% with intrathecal midazolam. No clinically adverse events caused by study agents were observed in either group. Conclusion: Intrathecal midazolam 2mg significantly reduces the incidence of nausea­vomiting when administered with 0.5% hyperbaric bupivacaine for cesarean section under spinal anesthesia.

Keywords: Nausea; Vomiting; Cesarean Section; Spinal Anesthesia; Metoclopramide; Intrathecal Midazolam.