Comparison of The Efficacy of Metochlopromide and Ondansatron for The Prevention of Nausea and Vomiting in Gynecological Surgeries

Abstract

Background: Postoperative nausea and vomiting (PONV) are common and distressing complications after gynecological surgeries, yet the comparative efficacy of metoclopramide and ondansetron for PONV prevention remains inadequately defined. Objective: To compare the efficacy of intravenous ondansetron versus metoclopramide in preventing PONV among women undergoing elective gynecological surgeries, focusing on incidence, severity, and rescue antiemetic requirements. Methods: This descriptive cross-sectional study was conducted at Government Teaching Hospital Shahdara, Lahore, over six months, enrolling 140 women aged 20–40 years undergoing elective gynecological surgeries under general or regional anesthesia. Patients were randomized to receive metoclopramide (10 mg IV) or ondansetron (4 mg IV) postoperatively. Data on PONV incidence, severity (VAS 0–10), and vomiting episodes were collected for 24 hours. Statistical analysis included t-tests, chi-square tests, and logistic regression using SPSS v25. Ethical approval was obtained per the Helsinki Declaration, and written informed consent was secured. Results: Ondansetron significantly reduced the incidence of nausea (30.0% vs. 58.6%, p = 0.021; OR: 0.31, 95% CI: 0.15–0.64) and vomiting (18.6% vs. 40.0%, p = 0.032; OR: 0.35, 95% CI: 0.16–0.75) compared to metoclopramide. The mean severity of nausea was lower (4.18 ± 1.8 vs. 6.25 ± 2.1, p = 0.045), as was the number of vomiting episodes (1.89 ± 0.9 vs. 3.02 ± 1.2, p = 0.032). Rescue antiemetics were less frequently required with ondansetron (10.0% vs. 25.7%, p = 0.02). Conclusion: Ondansetron demonstrates superior efficacy over metoclopramide in preventing and reducing PONV in gynecological surgery patients, supporting its preferential use to improve recovery and patient satisfaction.