EFFECT OF METOCLOPRAMIDE AND PROPOFOL PLUS DEXAMETHASONE ON POSTOPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDER SPINAL ANESTHESIA

Abstract

BACKGROUND AND OBJECTIVE: One of common complications after spinal anesthesia are nausea and vomiting that can make different problems such as spasm, hypoxia and pulmonary aspiration. This danger is more in patients with full stomach, eye injury, head trauma, cesarean and laparoscopy. The purpose of this study was to determine the effect of propofol and metoclopramide associated with dexamethasone on postoperative nausea and vomiting in patients under spinal anesthesia.METHODS: In this clinical trial study 100 patients with ASA class I and II aged 16 to 60 years who underwent orthopedic surgical operation of lower limbs divided into two groups randomly (50 patients in each). Each group received 500 cc of Ringer serum before spinal anesthesia. Spinal anesthesia with 22cc of 5% lidocaine was performed in the sitting position. The first group received metoclopramide with dexamethasone and second one received propofol with dexamethasone 5 minutes before the end of the operation. Prevalence of nausea and vomiting in both groups was surveyed for 4 hours and then data was compared with each other.FINDINGS: The occurrence rate of nausea in metoclopramide group was higher than propofol group (28% versus 22%) that this difference was statistically significant (p=0.039). Occurrence of vomiting in patients received propofol associated with dexamethasone was considerably lower than the patients received metoclopramide associated with dexamethasone (12% versus 4%) (p= 0.007).CONCLUSION: According to the results of this study, propofol associated with dexamethasone reduce nausea and vomiting in patients under spinal anesthesia.

Keywords

• propofol
• metoclopramide
• dexamethasone
• nausea
• vomiting
• spinal anesthesia