A comparative study between metoclopramide and dexamethasone for prevention of post operative nausea and vomiting in laparoscopic cholecystectomy

Objective: to compare the prophylactic antiemetic effect of intravenous (iv) metoclopramide with dexamethasone. material and methods: a prospective study of 150 patients undergoing laparoscopic cholecystectomy was carried out in the department of anaesthesiology,khyber teaching hospital,peshawar,from april 2009 to october 2009. patients were divided into two groups. one group received metoclopramide 10 mg iv,while the second group received dexamethasone 8 mg iv. the anaesthetic regime and surgical procedure were standardized for all patients. nausea and vomiting were assessed immediately after operation,at hourly intervals for 4 hours,in the recovery room,and from 4 to 24 hours in the ward. results: the incidence of post operative nausea and vomiting (ponv),in the metoclopramide group was 20% after 0-4 hours,50% after 4-24 hours and 70% after 0-24 hours of surgery. the incidence of ponv in dexamethasone group was 16% after 0-4 hours,12% after 4-24 hours and 28% after 0-24 hours surgery. a statistically significant difference was observed in both groups in respect of postoperative nausea and vomiting in 4-24 hours and 0-24 hours with a p-value 0.000 each. conclusion: dexamethasone was found superior to metoclopramide as a prophylactic antiemetic in patients undergoing laparoscopic cholecystectomy.