Ondansetron versus metoclopramide and hyoscine as prophylaxis for nausea and vomiting post sleeve gastrectomy: Randomized controlled trial

Background: Since it began to be used intermittently in the 1950s, there has been an upward trend in bariatric surgery, with the use of this procedure increasing more than 20-fold since 2010. Among the adverse Postoperative Events, Nausea and Vomiting (PONV) following general anaesthesia and surgery were recorded as the most distressing and frequent, affecting on average somewhere between 30%-50% of patients, though the frequency of these events varies considerably. Aim: This study purports to determine which of the various drugs available were the most effective in controlling PONV in patients post sleeve gastrectomy. Methodology: A prospective, randomized controlled study with parallel groups was conducted with 45 patients, all of whom had undergone laparoscopic sleeve gastrectomy under general anaesthesia. The patients were enrolled on the study, and then 15 patients were allocated at random to each of three groups. Each patient was then carefully monitored for specific vital signs including Non-Invasive Blood Pressure (NIBP), peripheral capillary oxygen saturation (Sp02), heart rate, temperature and end-tidal CO2 (ETCO2). Episodes of nausea and vomiting were monitored and documented by the follow-up nurses Results: The study included 45 patients divided into three groups. The mean systolic blood pressure was 132.8 ± 6.6 mmHg among the first group, 131.3 ± 11.0 mm Hg for the second group, and 131.5 ± 12.3 mm Hg for the third group. Pulse rate was significantly higher among the first group. Regarding post-surgical complaints, abdominal pain was recorded among 13.3% of the first group, 20% of the second group, and 13.3% of the third group. Conclusions and recommendations: In conclusion, the study revealed no significant difference between the different drugs under study in terms of effects on the vital signs of the patients, except for heart rate. Nausea was the effect most frequently experienced for all drugs, while bloody vomiting was more frequent among patients on 10 mg of metoclopramide.