Efficacy of Oral Domperidone Vs. Metoclopramide in Preventing Postoperative Nausea and Vomiting After Total Abdominal Hysterectomy

Abstract

Postoperative nausea and vomiting (PONV) is still a common implication after surgery, especially in high risk procedures such as total abdominal hysterectomy. Dopamine D2 receptor antagonists generally used for PONV prevention include metoclopramide and domperidone both because of their antiemetic and prokinetic effects. This study was undertaken to determine whether oral domperidone and metoclopramide are equally effective and safe in preventing PONV in patients undergoing total abdominal hysterectomy under general anesthesia. A prospective, randomized study was performed in 50 female patients 16–70 years of age undergoing surgery. Participants were randomly assigned to one of 10 mg of oral domperidone or 10 mg of metoclopramide preoperatively, and received 10 mg of oral domperidone or 10 mg of metoclopramide preoperatively. The primary outcome was incidence of nausea and vomiting up to 24 hours postoperatively. Secondary outcomes included adverse effects and need for rescue antiemetics. The results showed no statistically significant difference between the two groups in PONV incidence (32% for domperidone and 28% for metoclopramide, p=0.7576). Nausea was reported in 20% of patients in the domperidone group and 16% in the metoclopramide group, while vomiting occurred more frequently in the domperidone group (28% vs. 16%) during the first 6 hours. Mild adverse effects such as headache and dizziness with both medications were well tolerated. Similarly, oral domperidone and metoclopramide both effectively prevent PONV after total abdominal hysterectomy, and are cost-effective and practical, especially in resource-limited settings.