[Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone in gynecological surgery]

Abstract

Background: The authors evaluated the efficacy of a combination of dexamethasone and metoclopramide for the prophylaxis of postoperative nausea and vomiting (PONV) after gynecological abdominal surgery.

Methods: One-hundred and seventeen patients scheduled for gynecological abdominal surgery were analyzed retrospectively. Patients were classified into three groups by anti-emetics administered; none (Group C, n = 38); metoclopramide 10 mg (Group M, n = 39); or a combination of metoclopramide 10 mg with dexamethasone 8 mg (Group MD, n = 40) at 30 to 60 minutes prior to the end of surgery. Anesthesia was induced by propofol and maintained with isoflurane-nitrous oxide inhalation and intermittent administration of fentanyl. Postoperative pain was treated with continuous subcutaneous infusion of pentazocine via a patient controlled analgesia device. PONV was assessed using a 5 rating verbal score in early (0-6 hr) and in late (6-24 hr) period.

Results: The 3 groups were similar in demographic characteristics. The incidence of nausea and vomiting in early period was significantly lower in Group MD compared with Group C and Group M. Rescue anti-emetic requirements were fewer in Group MD compared with Group C. There are no severe complications.

Conclusions: A combination of metoclopramide and dexamethasone was more effective in preventing PONV compared with metoclopramide alone.