N/V afer spinal

[ares8402]

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Got pimped on this the other day:

Women gets spinal before section and gets nauseated and vomits. Why?

Attending said it was d/t the hypotension.

I'm trying to find how hypotension causes nausea. Is is cerebral ischemia? Baroreceptor reflex? Something else?

Thanks

 

[dhb]

Women gets spinal before section and gets nauseated and vomits. Why?

Poor anesthetic management

Vagal response

 

[Mman]

Poor anesthetic management

👍

 

[BLADEMDA]

Neuraxial anesthesia also changes the function of the

gastrointestinal tract.



39 Sympathetic blockade by local

anesthetics creates unopposed vagal action, resulting in

gastrointestinal hyperactivity. The ef



ficacy of vagolytic

agents to relieve nausea during spinal anesthesia has

been taken as evidence of the importance of this

mechanism.



33


There are other mechanisms. Print out or read the review below from Anesthesiology:

http://www.angelfire.com/hi5/anaesthesia/articles/PONVinRA.pdf

 

[BLADEMDA]

Hypotension is a common occurrence during neuraxial

anesthesia. Low blood pressure may lead to brain stem

ischemia, which is thought to activate the circulatory, respiratory,

and vomiting centers grouped together in the

medulla.

32 Consequently, supplemental oxygen can relieve

nausea in such circumstances.

33 Other investigators

have speculated that hypotension rather leads to gut

ischemia and the release of emetogenic substances (

e.g.,

serotonin) from the intestines.

34 These different hypotheses

linking hypotension and PONV still need to be

clari

fied