Anti-emetic effect of low dose metoclopramide with dexamethasone and metoclopramide alone for post-operative nausea and vomiting after thyroidectomy. A prospective cohort study

Abstract Introduction Nausea and vomiting after thyroidectomy is one of the common post-operative complications with the incidence of up to 84%. It is a challenging problem that may leads to surgical wound dehiscence, hematoma, upper airway obstruction, severe dehydration, acid base and electrolyte imbalance. The aim of this study was to compare the anti-emetic effect and safety of low dose both metoclopramide and dexamethasone versus metoclopramide alone for the prevention of nausea and vomiting after thyroidectomy. Method A prospective cohort study was employed on 76 patients who underwent Thyroidectomy. The randomly selected study participants were grouped as either exposed or control. Patients who received both 5 mg intravenous metoclopramide and 4 mg dexamethasone were considered as exposed group while patients who received 10 mg metoclopramide alone were considered as control group. Post-operative nausea and vomiting, and side effects were recorded post operatively at 6, 12 and 24 h. Data was entered in to EPI info version 7 and then transferred to SPSS version 20 computer program for analysis. Based on their assumption the independent two sample t-test, Manny Whitney test and chi-square test were used. P- Value  Result As compared to control group, the first 24 h overall incidence of nausea and vomiting was significantly lower in exposed group, 63% versus 24% respectively. Severity of nausea at 6th, 12th and 24th were also reduced in exposed group. Post-operative sedation was significantly higher in control group (39.47%) than exposed group (16.79%). Although the difference was statistically not significant headache was also higher (26.31%) in control group. Conclusion Giving intravenous 5 mg metoclopramide with 4 mg dexamethasone before induction of general anesthesia was effective and safer than10mg intravenous metoclopramide alone for prevention of post-operative nausea and vomiting after thyroidectomy.