Comparison the effects of sin- gle intramuscular dose of haloperidol and metoclopra- mide and promethazine, in pre- venting postoperative nausea and vomiting due to intrathecal use of meperidine at Sina hospital, 2004-2006

Postoperative nausea and vomiting (PONV) is a very common side effect of intrathecal use of meperdine. Several drugs for preventing the PONV due to opioids are available currently; but none ofthem can be considered as gold standard. This study was designed to compare effects of haloperidol, metoclopramide and promethazine in preventing of PONV due to intrathecal use of meperidine. In a randomized clinical trial (RCT), effects of haloperidol, metoclopramide and promethazine in prventing PONV due to intrathecal use of meperidine were compared in 60 patients who had undergone orthopedic or urologic operations in Sina hospital from 2004 until 2006. In all patients spinal anesthesia protocol (100 mg lidocaine or 15 mg marcaine with 25 mg meperidine intrathecally) was the same. The patients were randomized to receive either haloperidol (2.5 mg IM, n=20) or metoclopramide (10 mg IM, n=20) or promethazine (25 mg IM, n=20). All the patients were evaluated for incidence of nausea and vomiting in definite intervals during first 24 hours after operation. The data were analyzed by SPSS with considering statistic level under 0.05. The prevalence of early nausea in haloperidol group (10%) was less in promethazine group (35%), and more in metoclopramide group (5%). Difference inearly nausea severity among study groups was statisitically significant (p=0.029). The prevalence of late nausea in study groups (5%) was the same, but severity of it was different. Only one patient in group had nausea in 12-24 hrs postoperation. The prevalence of early vomiting in haloperidol group (5%) was less in promethazine group (25%) (p=0.07) and the same in metoclopramide group (5%). The prevalence of late vomiting in haloperidol group (5%) was more in metoclopramide group (0) and the same in promethazine group (5%). None of patients in study groups had womiting in 12-24 hrs postoperation. For prevention of nausea and vomiting due to intrathecal meperidine in 0-4 hrs after initiation of surgery, metoclopramide and haloperidol are more effective than promethazine.