A randomized double-blinded placebo controlled study of four interventions for the prevention of postoperative nausea and vomiting in maxillofacial trauma surgery

Abstract

Purpose: This study aimed to determine if preoperative oral administration of metoclopramide, chlorpromazine, gabapentin, or dexamethasone would effectively reduce postoperative nausea and vomiting (PONV) in the first 24 hours after surgery in patients undergoing maxillofacial trauma surgery.

Methods: One hundred fifty patients with maxillofacial skeletal trauma that need open reduction and internal fixation were randomly assigned to receive one of the following drugs orally, 1 hour preoperative: 10 mg metoclopramide (group A), 300 mg gabapentin (group B), 100 mg chlorpromazine (group C), 5 mg dexamethasone (group D), and placebo (group E). All patients were observed in the first 24 hours for PONV. Data analysis was done with the SPSS software (version 19), using chi-square test, Fisher exact test, and multiple logistic regression methods.

Results: The incidence of vomiting was significantly lower in groups A (2/30), B (3/30), and C (2/30) compared with the placebo group (9/30) (P < 0.05). Also, the incidence of postoperative nausea was significantly high in the placebo group (11/30) as compared to treatment groups A (2/30), B (3/30), and C (3/30) (P < 0.05). No significant differences in the incidence of PONV were found between groups D (7/30) and E (P > 0.05). Of all demographic variables, anesthesia time (P = 0.034) and surgery time (P = 0.047) were predictors of PONV.

Conclusion: Our results demonstrated that premedication with oral metoclopramide, gabapentin, or chlorpromazine can significantly decrease the incidence of PONV in patients undergoing maxillofacial trauma surgery.