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

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.