Muhammad Jamil, Syed Mushtaq Gilani, Shamsher Ali Khan


Background: Postoperative nausea and vomiting following anaesthesia and surgery are common
and can create considerable problems regarding management of patients and outcome of the
surgical procedure. Methods: This study evaluates and compares the efficacy and safety of the
metochlopramide to that of prochlorperazine in the prevention of postoperative nausea and
vomiting after tonsillectomy in young adult patients. 150 patients, of either sex, undergoing
tonsillectomy under the same anaesthetic technique were studied in a randomized, double blind,
placebo controlled manner. Either metoclopramide 0.1-0.2 mg kg-1, prochlorperazine 0.1-0.2 mg
kg -1 or 5% Dextose and normal saline (5% D/N.S) (2ml) as placebo was injected intravenously 10
minutes before induction of general anaesthesia. Episodes of nausea, retching/ vomiting, adverse
events, vital signs, the need for rescue antiemetic drug ( metoclopramide 0.1-0.2 mg kg–1 IV) were
recorded until four hours from the end of the surgical procedure. Results: The overall frequency
of PONV was 18%, 16%, and 24% in group A (metoclopramide), B (prochlorperazine) and C
(placebo) respectively. The need for rescue antiemetic was 2%, 8% and 12% in Prochloperazine
group, metoclopramide group and control group respectively. These differences did not reach
statistical significance (P>0.05). During the study period 82%, 84% and 76% of patients in group
A, B and C respectively were found free from postoperative nausea and vomiting, and no adverse
events related to either of the test medication were noted in any patient. Conclusion: It is
concluded that the differences in the results of occurrence of PONV in the experimental group and
control group are not statistically significant. However either Prochloperazine 0.1 – 0.2 mg kg-1 or
metoclopramide 0.1 – 0.2 mg kg-1 can be safely administered as Prophylactic antiemetic till the
availability of more efficacious and safe antiemetic drugs.
Keywords: Postoperative nausea and vomiting (PONV), metoclopramide, prochlorperazine,

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