Comparison of Metoclopramide, Dexamethasone and Their Combination for Prevention of Postoperative Nausea and Vomiting in Strabismus Surgery

The effect of a single preoperative intravenous (iv) administration of metoclopramide, dexamethasone, metoclopramide plus dexamethasone or placebo on the reduction of postoperative nausea and vomiting (PONV) after strabismus surgery was evaluated in 132 patients, 2-14 years of age, ASA (American Society of Anesthesiologists) physical status 1, undergoing strabismus surgery using a randomized, double blind, placebo controlled protocol.
The patients received either metoclopramide 150 g/kg, dexamethasone 150 g/kg, combination of them or the same volume of isotonic sodium chloride solution IV, 30 minutes before the induction of anesthesia. General anesthesia was performed with thiopental of Na, fentanyl, succinylcholine and maintained with halothane and N2O in all groups.
PONV were evaluated postoperatively. Patients in group III who received metoclopramide plus dexamethasone experienced significantly less PONV during the first 24 h after surgery.
In conclusion, a single dose of metoclopramide plus dexamethasone (150 g/kg of each drug) seemed to produce better antiemetic effects after strabismus surgery than metoclopramide or dexamethasone alone.