Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 22;7(4):e57810.
doi: 10.5812/aapm.57810. eCollection 2017 Aug.

Comparison Effect of Promethazine/Dexamethasone and Metoclopramide /Dexamethasone on Postoperative Nausea and Vomiting after Laparascopic Gastric Placation: A Randomized Clinical Trial

Mohammad Talebpour  1 , Naser Ghiasnejad Omrani  2 , Farsad Imani  2 , Reza Shariat Moharari  2 , Pejman Pourfakhr  2 , Mohammad Reza Khajavi  2
Affiliations

Comparison Effect of Promethazine/Dexamethasone and Metoclopramide /Dexamethasone on Postoperative Nausea and Vomiting after Laparascopic Gastric Placation: A Randomized Clinical Trial

Mohammad Talebpour et al. Anesth Pain Med. .

Abstract

Background: Laparoscopic gastric plication (LGP) is a technique in the restrictive category of bariatric procedures that reduces the gastric volume and increases intragastric pressure. Nausea and vomiting are the most common complications after this procedure. The goal of this research is to compare the combined effect of promethazine/dexamethasone versus Metoclopramide/ dexamethasone on the prevention of nausea and vomiting after LGP.

Methods: In recovery, the patients were divided into two groups, the Metoclopramide group which was given Metoclopramide 10 mg plus dexamethasone 4 mg/8 hours intravenous for 48 hours, and the promethazine group which was given promethazine 50 mg /12 hours, intramuscular for the first 24 hours and then promethazine 25 mg/12 hours for the next 24 hours plus dexamethasone 4 mg/8 hours intravenous for 48 hours. The frequency of nausea and vomiting, number of reflux episodes, frequency of epigastric fullness, and the duration of walking around q12 hours were recorded in the first 48 hours post-operation.

Results: Eighty patients were enrolled into the study. Promethazine group were found to significantly reduce the incidence of PONV in the first 24 hours compared with the other group (41% vs. 97.5%), relative risk = 0.042 [95% CI = 0.006, 0.299]. The mean numbers of epigastric fullness and severity of epigastria pain were lower in the promethazine group (P = 0.01) and the total opioid requirement was also reduced in promethazine group (32.1 ± 2.6 VS .68.5 ± 4.6 mg). However, the patients in the promethazine group were more sedated, which caused the duration of walking q12 hours in this group to decrease.

Conclusions: In morbidly obese patients undergoing laparoscopic gastric plication, promethazine/dexametasone was more effective than Metoclopramide/dexametasone in preventing and reducing the incidence of nausea, epigastric fullness, and reflux. That combination was also more effective than Metoclopramide in reducing the severity of epigastric pain.

Keywords: Dexamethasone; Laparoscopic gastric plication; Metoclopramide; Nausea; Promethazine; Vomiting.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest:No conflict of interest.

Figures

Figure 1.
Figure 1.. The Enrollment Flow Chart of the Patients
Figure 2.
Figure 2.. Mean Frequency of Nausea after Operation (P = 0.01)
Figure 3.
Figure 3.. Mean Epigastric Pain Score Post Operation (P = 0.01)
Figure 4.
Figure 4.. Mean Frequency of Reflux After Operation (P = 0.02)
Figure 5.
Figure 5.. Mean Frequency of Epigastric Fullness After Operation (P = 0.02)
Figure 6.
Figure 6.. Mean Duration of Walking After Operation (P = 0.01)
See this image and copyright information in PMC

References

    1. Darabi S, Talebpour M, Zeinoddini A, Heidari R. Laparoscopic gastric plication versus mini-gastric bypass surgery in the treatment of morbid obesity: a randomized clinical trial. Surg Obes Relat Dis. 2013;9(6):914–9. doi: 10.1016/j.soard.2013.07.012. - DOI - PubMed
    1. Niazi M, Maleki AR, Talebpour M. Short-term outcomes of laparoscopic gastric plication in morbidly obese patients: importance of postoperative follow-up. Obes Surg. 2013;23(1):87–92. doi: 10.1007/s11695-012-0777-y. - DOI - PubMed
    1. Chouillard E, Schoucair N, Alsabah S, Alkandari B, Montana L, Dejonghe B, et al. Laparoscopic Gastric Plication (LGP) as an Alternative to Laparoscopic Sleeve Gastrectomy (LSG) in Patients with Morbid Obesity: A Preliminary, Short-Term, Case-Control Study. Obes Surg. 2016;26(6):1167–72. doi: 10.1007/s11695-015-1913-2. - DOI - PubMed
    1. Barrett TW, DiPersio DM, Jenkins CA, Jack M, McCoin NS, Storrow AB, et al. A randomized, placebo-controlled trial of ondansetron, metoclopramide, and promethazine in adults. Am J Emerg Med. 2011;29(3):247–55. doi: 10.1016/j.ajem.2009.09.028. - DOI - PubMed
    1. Moeini A, Rastad H, Eslami B, Manouchehrian N, Sanatkar M. The Effect of Dexamethasone on Nausea and Vomiting during Labor and Labor Pain in Parturients Undergoing Normal Vaginal Delivery. Arch Anesthesiol Crit Care. 2015;1(4):126–9.

LinkOut - more resources