Comparison of the effect of intravenous midazolam, metoclopramide and their combination on the treatment of postoperative nausea and vomiting: A double blinded randomized clinical trial

Sayyed Morteza Heidari, Mojtaba Rahimi, Fater Saeb, Amir Shafa


Objective: Postoperative nausea and vomiting (PONV) are known to be among the most common and undesirable postoperative complications. The aim of this study was to compare the effect of midazolam (IV), metoclopramide (IV) and a combination of both as a treatment for established PONV.
Methodology: One hundred and thirty two males and females who experienced PONV following general anesthesia for cholecystectomy were enrolled in the study. Patients were allocated randomly into three groups of 44 individuals using a random number table. The first group received midazolam (30 g/kg, Max 2mg, IV), intravenous metoclopramide (0.15 mg/kg, Max 10 mg) was administered to the second group, and the third group was treated with a combination of midazolam and metoclopramide with mentioned doses. The frequency of vomiting and nausea (with Visual Analog Scale (VAS) > 3) were measured and registered at two, six and 24 hours after drug administration. Drug side effects were also recorded and compared.
Result: The frequency of nausea (VAS > 3) recorded six hours after the administration of injection has been significantly higher in the second group. No other significant differences were detected through the comparison between other values. There were no significant differences among the drug side effects in the three groups.
Conclusion: Administration of intravenous midazolam or midazolam-metoclopramide combination is more effective than metoclopramide alone in the treatment of postoperative nausea. The incidence of adverse effects is not significantly in the three groups.

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