Metoclopramide role in preventing ileus after cesarean, a clinical trial

Ileus is a common event following cesarean section. Early post-cesarean recovery is very important not only for the mother but also for the baby who is dependent on breastfeeding. This article aims to demonstrate the efficacy of metoclopramide for the prevention of ileus after cesarean.

In this randomized controlled trial, 696 women scheduled for cesarean were randomized in two groups. Three hundred fifty-three persons settled in control group and 343 were assigned in intervention group who received an injection of 10-mg intramuscular metoclopramide prior to operation. After cesarean, the participants recorded the first flatus, defecation, feeling of hunger, feeding and ambulation in a questionnaire, and also their sense of bloating in a visual analog scale under supervision of a research assistant. The data was analyzed by SPSS 17, t test, and chi-square, while p < 0.05 was considered significant.

The interval between cesarean and the first flatus (p < 0.0001), defecation (p < 0.0001), feeling of hunger (p < 0.0001), feeding (p = 0.007), and ambulation (p < 0.0001) were significantly shorter in the metoclopramide group. In addition, polytomous logistic regression analysis showed the metoclopramide group had less bloating with significant difference (OR = 2.83 and CI 1.91-4.21).

Our study proved the functionality of metoclopramide in preventing ileus. As this drug is safe, tolerable, harmless, inexpensive and available, and also no definite method has been developed to prevent ileus after cesarean; yet, metoclopramide could be considered as a suitable option. Certainly with regard to some limitations in our study, further comprehensive studies are still required to ensure validity of the obtained results.