Ondansetron vs. metoclopramide for the prevention of nausea and vomiting after gynecologic surgery

Abstract

Background: Postoperative nausea and vomiting (PONV) remains a very troublesome concomitant phenomenon after general anesthesia. The present study was designed to compare the efficacy and safety of ondansetron with metoclopramide for prophylaxis of PONV in patients undergoing major gynecological surgery.

Material and method: A prospective, randomized, double-blind, 382 female patients received either ondansetron 4 mg or metoclopramide 10 mg intravenous administration immediately before the induction of anesthesia. A standard general anesthetic technique was employed throughout. Nausea, vomiting, and safety assessments were performed continuously during the 24 h postoperative period.

Results: Of the 380 patients evaluated, significantly fewer ondansetron 4 mg treated patients (89/189; 47%) experienced postoperative nausea and/or vomiting compared with metoclopramide treated patients (115/ 191; 60%) during the study period (p = 0.007, 95% CI: 1.07, 1.66). Postoperative adverse events were not significantly different between the groups.

Conclusion: Prophylactic use of ondansetron is more effective than metoclopramide for preventing PONV in patients undergoing major gynecological surgery.