Incidence and severity of postoperative nausea and vomiting are similar after metoclopramide 20 mg and ondansetron 8 mg given by the end of laparoscopic cholecystectomies

Acta Anaesthesiol Scand. 2002 Jan;46(1):109-13.


Background: Ondansetron has a well documented antiemetic prophylactic effect, whereas in most studies of postoperative nausea and vomiting (PONV), metoclopramide is less efficacious. This can be attributed to the short-lasting effect of metoclopramide when a low dose is given at the beginning of surgery. We wanted to test a 20-mg dose of metoclopramide given at the end of surgery, using ondansetron 8 mg as a reference.

Methods: 122 patients scheduled for elective laparoscopic cholecystectomy under general anesthesia were studied in a randomized, double-blind study design. At the end of the procedure, the patients received either metoclopramide 20 mg or ondansetron 8 mg intravenously. The patients were observed for 24 h for PONV, pain, side-effects and need for rescue antiemetic medication.

Results: No significant differences in the incidence of PONV or need for rescue antiemetic treatment was observed in the 0-24 h postoperative study period. The overall incidence of PONV was 43% in the ondansetron group and 47% in the metoclopramide group. The ondansetron patients had a significantly higher incidence of moderate or strong pain during the postoperative observation period (61% vs. 35% in the metoclopramide group) (P < 0.05). No significant differences in side-effects between the groups were observed.

Conclusions: Metoclopramide 20 mg i.v. given at the end of laparoscopic cholecystectomy resulted in a similar incidence of PONV compared with ondansetron 8 mg. The patients receiving metoclopramide had less pain than the patients receiving ondansetron.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesia, General
  • Antiemetics / administration & dosage*
  • Antiemetics / adverse effects
  • Cholecystectomy, Laparoscopic* / adverse effects
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Metoclopramide / administration & dosage*
  • Metoclopramide / adverse effects
  • Middle Aged
  • Ondansetron / administration & dosage*
  • Ondansetron / adverse effects
  • Pain, Postoperative / prevention & control
  • Postoperative Nausea and Vomiting / prevention & control*
  • Prospective Studies


  • Antiemetics
  • Ondansetron
  • Metoclopramide