OPEN CHOLECYSTECTOMY

MANAGEMENT OF PONV: COMPARISON OF SUB HYPNOTIC DOSE OF PROPOFOL vs METOCLOPRAMIDE

Abstract

Background: Postoperative nausea and vomiting (PONV) are most common and distressing complications after anaesthesia and surgery, leading to various problems. Metoclopramide, a benzamide, used as an anti-emetic, has got various side-effects. Propofol, a short acting induction agent, possesses anti-emetic properties in sub hypnotic doses, without having unwanted side- effects in this low dose. Objectives: To compare the frequency of PONV in patients treated with propofol and metoclopramide. Study Design: Experimental study. Setting: Department of anaesthesia and intensive care, Combined Military Hospital Rawalpindi. Duration: 06 months (01st July to 31st December 2004). Materials and Methods: 182 female patients scheduled for open cholecystectomy were selected for this study. All of them received general anaesthesia without any prophylactic antiemetic. Out of them, 60 patients who complained of PONV in post anaesthesia care unit (PACU) were selected by non probability convenience sampling and were equally divided into two groups. Group ‘A’ received propofol (0.5 mg/kg) while group ‘B’ received metoclopramide (0.2 mg/kg). Recurrence of PONV was recorded 60 min after administration of the study drug. Patients still complaining of PONV 30 min after administration of the study drug received a rescue medication i.e. I/V ondansetron (4mg). Results: In group “A”,18 patients responded to intervention (60%) whereas 26 (86.66%) patients gave a positive response in group “B” (p 0.020). More patients who received propofol needed the rescue medication (40%) than those who received metoclopramide (13.33%) (p 0.020). Conclusion: Metoclopramide is a better option for managing PONV than propofol.