A COMPARATIVE STUDY OF ONDANSETRON VERSUS METOCLOPRAMIDE IN THE PREVENTION OF POST-OPERATIVE VOMITING IN ROUTINE MAJOR GYNECOLOGICAL SURGERY UNDER GENERAL ANESTHESIA

Abstract

This is a comparative study of ondansetron versus metoclopramide in the prevention of post-operative
vomiting in routine major gynecological surgery under general anesthesia. The purpose of this study was to
perform a comparative study of injection ondansetron 8 mg I.V. with injection metoclopramide 10 mg I.V.
in preventing post-operative vomiting.This was a randomized, double blinded study conducted in sixty
patients of American Society of Anaesthesiologist (ASA) I and ASA II undergoing routine major gynecological
surgery (Transabdominal Hysterectomy, laprotomy and cystectomy, tubal surgery) under general anesthesia.
Either of the drug was diluted to 5 ml of normal saline and given intravenously prior to induction of
anesthesia. The post-operative period of first 24 hours was divided into two phases, the early (0-6 hrs.) and
late (6-24 hrs.). The frequencies of vomiting and requirement of rescue antiemetics in both groups were
studied. The general characteristics of the patients in the two groups were similar. In both groups, induction,
maintenance, duration of anesthesia as well as the type of surgery and opioids requirement were similar.
The data recorded were statistically analyzed using Chi -square test and t - test. The frequency of vomiting
was less in ondansetron group compared to metoclopramide group. Rescue antiemetics was given only once
in ondansetron group patients, whereas the need of rescue antiemetics was eight times in the metoclopramide
group. The difference was statistically significant (p=0.03). No unwanted effects were noticed in both groups.
Ondansetron seems more effective in preventing Post-Operative Nausea & Vomiting (PONV) than
metoclopramide but it has to be evaluated further by more clinical trials and tests in larger series.

Key Words: Antiemetics, vomiting, general anesthesia, gynaecological surgery.