Comparison of Metoclopramide and low dose Propofol for prophylaxis of nausea & vomiting after cesarean section

Nausea and vomiting after surgery and anesthesia, cause longer stay of the patient in recovery room and also leads to complications such as electrolyte disturbances, dehydration, hemorrhage from the site of sutures and pulmonary aspiration. This study compared the preventive effect of metoclopramide and low-dose propofol on nausea and vomiting after cesarean section.. In this double blind clinical trial, 120 candidate patients for cesarean section (C/S) were randomly divided into two groups. The age range of patients was 17 to 34 years and all were in ASA class 1 and 2. Anesthesia induced in the same condition for all patients. 3 minutes before the end of surgery, all inhaled drugs were stopped and in one group, propofol (0.5 mg/kg) and in the other group, metoclopramide (0.2 mg/kg) was administered. All the patients had been controlled for nausea and vomiting up to 6 hours post-operation. Data were analyzed by means of SPSS, using t-test and chi-square at the significant level of P<0.05. There was no significant difference on age, weight and duration of surgery between the two groups. The frequency of vomiting in 1 hour after surgery in propofol treatment group (16.7%) was significantly less than metoclopramide treatment group (55%) (P<0.0001). However, there was no significant difference in 2-6 hours after surgery (36.7% and 51.7% respectively, P>0.05). Frequency of nausea in propofol treatment group in the first (30%) and 2-6 hours (36.7%) after surgery was significantly lower than the metoclopramide group(60% and 58.3%, respectively; P<0.01). Propofol (0.5 mg/kg) in the prophylaxis of nausea and vomiting in the first hour after C/S was more effective than metoclopramide. Moreover, its effect on lowering the frequency of nausea in the 2-6 hours postoperative was more than metoclopramide.