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When it comes to preventing nausea and vomiting after a C-section, dexamethasone and ondansetron appear to be equally effective. A new randomized controlled trial found no significant difference between the two drugs in postoperative medication use, pain scores, or nausea outcomes in the first 24 hours after cesarean delivery.
When it comes to preventing nausea and vomiting after a C-section, dexamethasone and ondansetron appear to be equally effective.
A prospective randomized controlled trial published in Anesthesia & Analgesia compared dexamethasone 8 mg vs. ondansetron 4 mg as first-line antiemetic prophylaxis in 95 women undergoing cesarean delivery under spinal anesthesia. All participants followed a standardized enhanced recovery after cesarean (ERAC) pathway, and researchers tracked medication use, pain scores, and nausea outcomes over the first 24 hours post-delivery.
The results showed no meaningful differences across the board. Both groups required similarly low numbers of rescue medications, and pain and nausea scores were comparable at every measured timepoint.
By the Numbers:
Why it matters: With no clear winner between the two drugs, clinicians have flexibility in choosing antiemetic prophylaxis for C-section patients — particularly within ERAC protocols — based on individual patient factors, cost, or availability rather than efficacy differences.
