Does the administration of oral Bicitra before elective cesarean section affect the incidence of nausea and vomiting in the parturient?

Abstract

Soluble oral antacids are commonly used before anesthesia for cesarean section. The purpose of this prospective, single institution, randomized experimental study was to examine the relationship of oral administration of Bicitra (sodium citrate and citric acid) to the incidence of nausea and vomiting in patients undergoing elective cesarean section utilizing regional anesthesia, and to evaluate its effectiveness in neutralizing gastric acid. Eighty-six patients were studied (39 in a control group and 47 in a Bicitra treatment group) to ascertain if there was any difference with regard to height, weight, parity, gravity, age, race, incidence of heartburn with pregnancy, incidence of nausea with pregnancy, length of NPO status, preoperative systolic blood pressure (SBP), perioperative low level of SBP, and cumulative drop in SBP. Pearson chi square analysis showed no significant difference between the two groups for all variables or the incidence of nausea and vomiting. No significant difference was noted in the mean pH and volume of emesis of seven subjects analyzed using pooled t tests. After initial hypothesis testing was concluded, the sample was divided into two groups, those who experienced nausea and those who were free from nausea. The nausea group demonstrated a significantly greater cumulative decrease in SBP than did the non-nausea group. Larger patients (mean cube root weight index of 2.78) tended to become nauseated more frequently.