Comparison of the effects of two drug combinations metoclopramide-acetaminophen, and metoclopramide-ketamine on postoperative pain, nausea, and vomiting after deep vitrectomy surgery- A randomized controlled clinical trial

According to the high incidence and complications of postoperative pain, nausea, and vomiting the current study aimed to assess the combination of acetaminophen-metoclopramide and ketamine-metoclopramide in comparison with a control group in decreasing post-vitrectomy pain, nausea, and vomiting.

The current randomized clinical trial has been conducted on 96 patients undergoing elective deep vitrectomy in three treatment groups of acetaminophen-metoclopramide(n=32) which received acetaminophen (10 mg/kg) and metoclopramide (0.15 mg/kg); ketamine-metoclopramide(n=32) which received ketamine (0.1 mg/kg) and metoclopramide (0.15 mg/kg); and the control group (n=32) who received 100 ml of sterile normal saline, all of the drugs were infused intravenously and within 20 minutes before the end of the procedure.  Pain and nausea intensity based on Visual Analogue Scale (VAS) and vomiting incidence and vital signs in the first postoperative 24 hours were assessed.

Hemodynamic parameters did not statistically differ between the study groups during the first 24 hours after surgery. Significant improvements were noticed in all the groups regarding pain, nausea intensity, and vomiting incidence in all the groups (P-value<0.05); however, the comparison of the groups showed the lowest pain (P-value=0.001), nausea (P-value=0.04) intensity scores and vomiting incidence (P-value=0.01) in ketamine-metoclopramide treated patients.

Based on the findings of this study, both acetaminophen-metoclopramide and ketamine-metoclopramide significantly reduced pain, nausea, and vomiting; however, generally, ketamine-metoclopramide had better results. None of the drug compounds caused serious side effects and hemodynamic disturbances