The morphine-sparing effect of metoclopramide on postoperative laparoscopic tubal ligation patients

Metoclopramide traditionally has been used as a prokinetic and antiemetic, but recently it also has been investigated as an agent to enhance analgesic efficacy. No definitive studies have been undertaken to determine whether metoclopramide can decrease postoperative analgesic requirements. The present study examined the effects of the administration of metoclopramide on the postoperative opioid analgesic requirements and pain intensity scores of patients following laparoscopic bilateral tubal ligation under general anesthesia. Fifty-six subjects were enrolled in this double-blind, placebo-controlled, prospective study. Subjects were randomized into 2 groups, a control placebo group (n = 30) and an experimental metoclopramide group (n = 26), and were assessed for pain intensity using a numeric rating scale. Assessments were recorded at 3 time intervals. Total postoperative opioid requirements also were recorded. Numeric rating scale pain scores were noted to be similar in both groups at all 3 time intervals examined. However, total postanesthesia care unit (PACU) morphine requirements were significantly higher in the placebo group than the metoclopramide group (P = .031). This study demonstrated that metoclopramide administered preoperatively can significantly decrease morphine requirements in the PACU but had no impact on pain intensity as rated by numeric rating scale pain scores.