Efficacy of ginger on intraoperative and postoperative nausea and vomiting in elective cesarean section patients

Objective: To evaluate the efficacy of dry powdered ginger, given orally, on nausea and vomiting during and after an elective cesarean section performed under combined spinal epidural anesthesia.

Study design: 239 women, ginger (n=116) and placebo (n=123), who underwent elective cesarean section at term under combined spinal-epidural anesthesia were provided with standard preoperative antiemetic treatment in addition to a randomized study drug. They were given two capsules (1g each) of either dry powdered ginger or placebo, one capsule a half-hour before induction of anesthesia and the second 2h after surgery. The study was double-blinded and the incidences of nausea and vomiting were assessed both intraoperatively and postoperatively. Levels of pain and pruritus were also assessed postoperatively.

Results: The intraoperative incidence of nausea was 52% and 61%, ginger versus placebo (p=0.149). The number of episodes of intraoperative nausea was less in the ginger group compared to placebo (mean difference was -0.396, 95% CI -0.738, -0.054) and the result was statistically significant (p=0.023). The incidence of intraoperative vomiting was 27.35% in the ginger group and 36.59% in the placebo group, and the difference was not statistically significant (p=0.126). The number of episodes of vomiting during surgery was less in the ginger group compared to placebo: (mean difference -0.158, 95% CI -0.626, 0.311) although statistically insignificant (p=0.505). Furthermore, postoperatively, there was no statistical difference in the incidence of nausea and vomiting assessed at 0, 2, 2 ½ and 24h after surgery. There were also no differences in postoperative pain or pruritus.

Conclusion: Ginger given in dry powdered form reduced the number of episodes of intraoperative nausea compared to a placebo, but it had no effect on incidence of nausea, vomiting, or pain during and after an elective cesarean section performed under combined spinal epidural anesthesia.