Anjali P. Savargaonkar1, Kavitha Chendhilkumar2, Rajesh V. Nagmothe3
This prospective double blind randomized study was conducted to compare: 1. The efficacy and safety of prophylactic administration of Metoclopramide versus Ondansetron in the control of postoperative nausea and vomiting in patients receiving intravenous Tramadol as postoperative analgesic. 2. To study the incidence of postoperative nausea and vomiting with IV bolus Tramadol. METHODS: 90 patients ASA grade I and II, age 18-60 years, posted for hernia, hydrocele and other peripheral lower limb surgeries under subarachnoid block were selected. Patients were randomly allocated into three groups of thirty each. All surgeries were performed under subarachnoid block and received IV Tramadol 100 mg 8 hourly for 24 hours as post-operative analgesic. Group N received no prophylactic antiemetic. Group M received 10 mg Metoclopramide 12 hourly. Group O received 4 mg Ondansetron 12 hourly. Vital signs, nausea, vomiting, pain, sedation, need for rescue antiemetic, rescue analgesic and adverse effects were recorded for 24 hours. RESULTS: Ondansetron group (Group O) significantly reduced the incidence of PONV as compared to Metoclopramide (Group M) and no antiemetic group (Group N).But Metoclopramide was found to be not significantly effective in controlling PONV in patients receiving Tramadol as analgesic. None of the patients in Group O required rescue antiemetic as compared to 13.3% patients in Group M and 26.7% patients in Group N. There was statistically no significant difference between the 3 groups with respect to requirement of rescue analgesic. No major adverse effects were observed which can be attributed to either Metoclopramide or Ondansetron. CONCLUSION: Ondansetron was more effective than Metoclopramide in controlling PONV, in patients receiving IV Tramadol as post- operative analgesia.