A randomized double-blinded placebo controlled study of four interventions for the prevention of postoperative nausea and vomiting in maxillofacial trauma surgery.
OBJECTIVE
This study aimed to determine if preoperative oral administration of metoclopramide, chlorpromazine, gabapentin, or dexamethasone would effectively reduce postoperative nausea and vomiting (PONV) in the first 24 hours after surgery in patients undergoing maxillofacial trauma surgery.


METHODS
One hundred fifty patients with maxillofacial skeletal trauma that need open reduction and internal fixation were randomly assigned to receive one of the following drugs orally, 1 hour preoperative: 10 mg metoclopramide (group A), 300 mg gabapentin (group B), 100 mg chlorpromazine (group C), 5 mg dexamethasone (group D), and placebo (group E). All patients were observed in the first 24 hours for PONV. Data analysis was done with the SPSS software (version 19), using chi-square test, Fisher exact test, and multiple logistic regression methods.


RESULTS
The incidence of vomiting was significantly lower in groups A (2/30), B (3/30), and C (2/30) compared with the placebo group (9/30) (P < 0.05). Also, the incidence of postoperative nausea was significantly high in the placebo group (11/30) as compared to treatment groups A (2/30), B (3/30), and C (3/30) (P < 0.05). No significant differences in the incidence of PONV were found between groups D (7/30) and E (P > 0.05). Of all demographic variables, anesthesia time (P = 0.034) and surgery time (P = 0.047) were predictors of PONV.


CONCLUSIONS
Our results demonstrated that premedication with oral metoclopramide, gabapentin, or chlorpromazine can significantly decrease the incidence of PONV in patients undergoing maxillofacial trauma surgery.
From the *Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz; and †Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
Hamidreza Eftekharian
HE
Jahromi
Mehdi
M
Gholami
Fariborz
F
Rezaei
D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000588:Amines / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use*; D002648:Child; D002746:Chlorpromazine / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D000077206:Gabapentin; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008446:Maxillofacial Injuries / Q000601:surgery*; D008787:Metoclopramide / Q000627:therapeutic use; D008875:Middle Aged; D010919:Placebos; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011292:Premedication; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D000932:Antiemetics; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists; D005938:Glucocorticoids; D010919:Placebos; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D003907:Dexamethasone; D008787:Metoclopramide; D002746:Chlorpromazine