الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The overall incidence of intraoperative nausea and vomiting (IONV) during regional anesthesia for cesarean section is extremely variable, up to 80%, depending on the anesthetic technique used (spinal, epidural or combined spinal-epidural) and on the preventive and therapeutic measures taken. Spinal anesthesia for CS is safe and effective; it is currently the anesthetic technique of choice for elective cesarean delivery (CD). However, maternal hypotension associated with spinal anesthesia is one of the primary causes of intraoperative nausea and/or vomiting (IONV); this symptom is thought to be caused by cerebral and gut hypoperfusion that stimulate the vomiting centre in the brainstem and cause serotonin release, respectively. While bolus dosing of phenylephrine effectively treats maternal hypotension, it does not prevent intraoperative maternal nausea, which may be associated with established hypotension, and this may adversely affect patient satisfaction. However, the unopposed vagal activity that occurs with sympathetic block might be another cause of intraoperative nausea and vomiting during spinal anesthesia.