Efficacy of metoclopramide and dexamethasone for postoperative nausea and vomiting: a double-blind clinical trial

Postoperative nausea and vomiting are common complications of anaesthesia. This double-blind clinical trial assessed the incidence of nausea and vomiting after cataract surgery with intravenous anaesthesia in 100 patients randomly assigned to preinduction placebo [saline], metoclopramide [10 mg], dexamethasone [8 mg] or the 2 drugs combined. The incidence of nausea in the recovery room was 44% with placebo, 20% with metoclopramide, 16% with dexamethasone and 8% with the combination. The incidence of vomiting was 20%, 4%, 4% and 0% respectively in the 4 groups. Metoclopramide plus dexamethasone combination significantly decreased nausea and vomiting both in the recovery room and 24 hours afterwards and is recommended for high-risk groups, especially in outpatient surgeries

Comparison of alfentanil and remifentanil infusion during anesthesia on recovery time and nausea and vomiting incidence after ophtalmic surgery in elderly patients

Necessity for rapid and safe recovery of patients for coming back to daily life with consideration the daily - increased development of outpatient surgeries is the main point. This study is comparing recovery time post operative nausea and vomiting after the use of two rapid-onset narcotic, alfentanil and remifentanil in anesthesia of elderly patients. In this double-blind clinical trial 40 elderly patient scheduled to cataract surgery with general anesthesia were sthdied. The patients were selected randomly into two groups and in each group alfentanil or remifentanil was injected one minute before induction of anesthesia during 30 seconds. Both two groups were under general anesthesia with same method and during the anesthesia alfentanil and remifentanil infused for each group respectively. The time intervals between end of anesthesia and spontaneous respiration, eyes opening with simulation, verbal response, nausea and vomiting incidence in recovery and the time of discharge from recovery room were recorded. The time of spontaneous respiration in alfentanil group 1.3 minute was shorter than remifentanil group, But statistically, the difference was not significant [P=0.08]. The time of eyes opening with stimulation, verbal response and discharge of recovery room were not significantly different in two groups. During recovery, nausea and vomiting in remifentanil group [30% of patients] was significantly more than alfentanil group [5% of patients] [P=0.045]. With consideration that faster return of spontaneous respiration after infusion of alfentanil than remifentanil group and especially the significantly lower incidence of postoperative nausea and vomiting in alfentanil group, the infusion of alfentanil as opioid supplement in anesthesia of elderly patients especially in out patient surgery is suggested