[Prevention of postoperative nausea and vomiting by metoclopramide combined with dexamethasone in gynecological surgery].
BACKGROUND
The authors evaluated the efficacy of a combination of dexamethasone and metoclopramide for the prophylaxis of postoperative nausea and vomiting (PONV) after gynecological abdominal surgery.


METHODS
One-hundred and seventeen patients scheduled for gynecological abdominal surgery were analyzed retrospectively. Patients were classified into three groups by anti-emetics administered; none (Group C, n = 38); metoclopramide 10 mg (Group M, n = 39); or a combination of metoclopramide 10 mg with dexamethasone 8 mg (Group MD, n = 40) at 30 to 60 minutes prior to the end of surgery. Anesthesia was induced by propofol and maintained with isoflurane-nitrous oxide inhalation and intermittent administration of fentanyl. Postoperative pain was treated with continuous subcutaneous infusion of pentazocine via a patient controlled analgesia device. PONV was assessed using a 5 rating verbal score in early (0-6 hr) and in late (6-24 hr) period.


RESULTS
The 3 groups were similar in demographic characteristics. The incidence of nausea and vomiting in early period was significantly lower in Group MD compared with Group C and Group M. Rescue anti-emetic requirements were fewer in Group MD compared with Group C. There are no severe complications.


CONCLUSIONS
A combination of metoclopramide and dexamethasone was more effective in preventing PONV compared with metoclopramide alone.
Nonaka
Akihiko
A
Department of Anesthesia, Yamanashi Prefectural Central Hospital, Kofu 400-8506.
Suzuki
Satomi
S
Tamaki
Fumimasa
F
Furuya
Atsushi
A
Abe
Fumiaki
F
Matsukawa
Takashi
T
D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008787:Metoclopramide / Q000008:administration & dosage*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D012189:Retrospective Studies
D000932:Antiemetics; D003907:Dexamethasone; D008787:Metoclopramide