Comparison of prophylactic effect of intravenous Metaclopramide and ondansetron on postoperative nausea and vomiting (PONA) after maxillofacial surgery

Abstract

One of the postoperative complications is nausea and vomiting (PONV), which exert a more adverse effect on the patient than postoperative pain. Nausea and vomiting are dangerous and they are of special interest in maxillofacial surgeries in which the patient undergoes IMF (intermaxillary fixation) after the surgery and the mouth is closed; therefore, it can result in aspiration and patient suffocation. The aim of the present study was to compare the prophylactic effects of intravenous ondansetron and metoclopramide in maxillofacial surgery. METHODS: 175 patients with the age range of 18-50 years were randomly allocated into 5 groups. Four groups received ondansetron 0.15 mg/kg or metoclopramide 0.5 mg/kg intravenously in a double-blind manner 30 minutes before surgery or 30 minutes before recovery. In 5th Group (control); metoclopramide was administered in a routine manner of PRN without prophylaxis. RESULTS: The incidence of nausea and vomiting was highest in control group(C =33.01%) and lowest for ondansetron given 30 minutes before end of anaesthesia (Oa=4.71%). (p = 0.001). Half an hour after full consciousness was the most common period for incidence of nausea and vomiting (39.62%). Regarding the absence of PONV 24 hours after surgery; incidence of nausea and vomiting eight hours after regaining full consciousness, was 4.71%(p<0.001). The incidence of nausea and vomiting was 2.38% for ondansetron given before recovery (Oa) and 7.61% for 30 minutes before surgery (Ob); the difference was statistically significant (p = 0.045). CONCLUSION: Use of ondansetron is significantly more efficacious than metochlopramide in preventing PONV. The best administration time for that is 30 minutes before recovery.