COMPARISON OF METOCLOPRAMIDE, PROCHLORPERAZINE AND PLACEBO IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING (PONV) FOLLOWING TONSILLECTOMY IN YOUNG ADULTS

Authors

  • Muhammad Jamil
  • Syed Mushtaq Gilani
  • Shamsher Ali Khan

Abstract

Background: Postoperative nausea and vomiting following anaesthesia and surgery are commonand can create considerable problems regarding management of patients and outcome of thesurgical procedure. Methods: This study evaluates and compares the efficacy and safety of themetochlopramide to that of prochlorperazine in the prevention of postoperative nausea andvomiting after tonsillectomy in young adult patients. 150 patients, of either sex, undergoingtonsillectomy 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 mgkg -1 or 5% Dextose and normal saline (5% D/N.S) (2ml) as placebo was injected intravenously 10minutes before induction of general anaesthesia. Episodes of nausea, retching/ vomiting, adverseevents, vital signs, the need for rescue antiemetic drug ( metoclopramide 0.1-0.2 mg kg–1 IV) wererecorded until four hours from the end of the surgical procedure. Results: The overall frequencyof 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 Prochloperazinegroup, metoclopramide group and control group respectively. These differences did not reachstatistical significance (P>0.05). During the study period 82%, 84% and 76% of patients in groupA, B and C respectively were found free from postoperative nausea and vomiting, and no adverseevents related to either of the test medication were noted in any patient. Conclusion: It isconcluded that the differences in the results of occurrence of PONV in the experimental group andcontrol group are not statistically significant. However either Prochloperazine 0.1 – 0.2 mg kg-1 ormetoclopramide 0.1 – 0.2 mg kg-1 can be safely administered as Prophylactic antiemetic till theavailability of more efficacious and safe antiemetic drugs.Keywords: Postoperative nausea and vomiting (PONV), metoclopramide, prochlorperazine,tonsillectomy.

References

Watch MF, White PF. Postoperative nausea and

vomiting, its etology, treatment and prevention

Anesthesiology 1992; 77; 162-84.

Beattie WS, Lindblad T, Buckley DN, Forrest JB.

Mensturation increases the risk of nausea and vomiting

after laparoscopy, a prospective randomized study

Anesthesiology 1993;78; 272-76.

Lerman J. Surgical and patient factor involved

postoperative nausea and vomiting Br J Anaesth

;69(suppl-1);24S-32S.

Kamath B, Curran J, Hawkey C. Anaesthesia,

movement and emesis. Br J Anaesth 1990; 64; 728-30.

Andrews PLR. Physiology of nausea and vomiting Br J

Anaesth 1992; 69 (Supply -1); 2S-19S.

Bremner WGM, Kumar CM. Delayed surgical

emphysema Pneumomediastinum and bilateral

pneumothoraces after postoperative vomiting Br J

Anaesth 1993; 71:296-7.

Capouet V, De Pauw C, Vernet B. Single dose i, v

tropisetron in the prevention of postoperative nausea

and vomiting after gynecological surgery, Br J Anaesth

;76:54-60.

Shenkman Ze’ EV, Holzman RS, Kim E. AcupressureAcupuncture Antiemetic prophylaxes in children under

going Toxsillectomy Anesthesiology 1999; 90; 1311-6.

Florio TD. The use of midazolam for persistent

postoperative nausea and vomiting Anaesth Intensive

Care 1992; 20; 383-86.

Bowhayar, Mayha, Rudnicka AR. A randomized

controlled trail of the antiemetic effect of three doses of

ondansetron after strabismus surgery in children. Paed

Anaesth 2001; 11; 215-21.

Madej TH, Simpson KH. Comparison of the use of

domperidone, droperidol and metoclopramide in the

prevention of nausea and vomiting following major

metoclopramide surgery. Br J Anaesth 1986;58;884-7.

Tramer M, Moore A, McQuay H. Prevention of

vomiting after paediatirc strabismus surgery, a

systematic review using review using the numbers

needed to treat method. Br J Anaesth 1995;75:556-61.

Buther M, Walder B, Elm Fvetal. Is lower dose

haloperidol a useful antiemetic. A Meta-analysis of

published and unpublished Randomized trials.

Anesthesiology 2004;104:1454-63.

Van den Berg AA. Comparison of ondansetron and

prochloperazine for the prevention of nausea and

vomiting after adenotosillectiomy. Canjanaesth

;76; 449-51.

Knapp MR, Beecher HK. Postanaesthetic nausea,

vomiting and retching. JAMA 1956;160;376-85.

Bone Me, Wilkinson DJ, Young JR, McNeil J,

Charltron S. Ginger root a new antiemetic. The effect of

ginger root on postoperative nausea and vomiting after

major Gyneacological surgery. Anaesthesia

;45:669-71.

Honkavaara P. Effect of transdermal hyoscine on

nausea and vomiting during and after ear surgery under

local anesthesia. Br J Anaesth 1996;76:49-53.

Khan FA. Soomro NA, Kamal RS. A review of 6978

consecutive admission to the recovery room at a

university hospital J Pak Med Assoc 1991;41:2-6

Mckenzie R, Kovac A, Connor TO. Comparison of

ondansetron versus placebo to prevent postoperative

nausea and vomiting in woman undergoing ambulatory

gynaecologic surgery. Anesthesiology 1993;78:21-8.

Raphael JH, Norton AC. Antiemetic efficacy of

prophylactic ondansetron in laparoscopic surgery.

Randomized, double-blind comparison with

metoclopramide. Br J Anaesth 1993;71:845-8.

Rudra A. Comparison of ondansetron, metoclopramide

and placebo in the prevention of emetic episodes

following Cholecystectomy. Anesthesiology 1993;

XVII:14-17

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