The Effects of Prophylactic Metoclopramide and Induction with Propofol on Postoperative Nausea and Vomiting.

Park,  Hyun Hee; Park,  Kwan Sik; Lee,  Sook Young; Cho,  Oi Gyeong; Kim,  Jae Hyung; Kim,  Jin Soo; Shin,  Dong Wook

doi:2006.50.2.179

Randomized Controlled Trial

Korean Journal of Anesthesiology 2006;50(2):179-183.
DOI: https://doi.org/10.4097/kjae.2006.50.2.179

The Effects of Prophylactic Metoclopramide and Induction with Propofol on Postoperative Nausea and Vomiting.

Hyun Hee Park, Kwan Sik Park, Sook Young Lee, Oi Gyeong Cho, Jae Hyung Kim, Jin Soo Kim, Dong Wook Shin

¹Department of Anesthesiology and Pain Medicine, School of Medicine, Ajou University, Suwon, Korea. anesylee@ajou.ac.kr
²Department of Anesthesiology and Pain Medicine, School of Medicine, Jeju University, Jeju, Korea.

Abstract

BACKGROUND
Postoperative nausea and vomiting (PONV) are common problems in patients undergoing a laparoscopic cholecystectomy. This study evaluated the effect of prophylactic metoclopramide (MCP) and induction with propofol on PONV.
METHODS
165 patients undergoing laparoscopic cholecystectomy were randomly divided into four groups. Groups 1 (control group) and 2 were inducted with thiopental sodium. Groups 3 (propofol group) and 4 were inducted with propofol. Prophylactic metoclopramide 10 mg i.v. was administered in Groups 2 (MCP group) and 4 (propofol + MCP group). The incidence of PONV, the need for rescue antiemetics, adverse events, and the nausea severity scores were assessed at 0 to 1 hour and at 1 to 24 hours postoperatively.
RESULTS
During the first 24 hours after anesthesia, the incidence of PONV in Groups 1, 2, 3 and 4 was 41.5%, 29.3%, 30.3% and 23.3%, respectively. There was no significant difference between the groups. During the period, 1 hour to 24 hours, after anesthesia, the incidence of PONV in Groups 1, 2, 3 and 4 was 36.6%, 17.4%, 27.5% and 14.4%, respectively. The incidence of PONV in Group 4 was significantly lower than in Group 1 (P < 0.05).
CONCLUSIONS
In patients with laparoscopic cholecystectomy, a combination of prophylactic metoclopramide administration and induction with propofol was found to reduce the incidence of PONV by about 22.6% during the period 1 hour to 24 hours after anesthesia.

Key Words: laparoscopic cholecystectomy; metoclopramide; postoperative nausea and vomiting (PONV); propofol