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Does metoclopramide supplement postoperative analgesia using patient-controlled analgesia with morphine in patients
B I Danzer1, D J Birnbach, D J Stein
1St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Background And Objectives:
Recent studies have shown that metoclopramide may decrease postoperative narcotic requirements in patients undergoing second-trimester induced abortions or prosthetic hip surgery. It is often used to decrease the incidence of nausea and vomiting in the patient undergoing cesarean delivery under regional anesthesia. If metoclopramide were found to be an analgesic adjunct in these patients, it would offer an additional impetus for its routine use.
Methods:
After elective cesarean delivery under spinal anesthesia, 32 patients were monitored for initial and 24-hour postoperative morphine requirements via intravenous patient-controlled analgesia. These patients were divided into two groups. Prior to spinal block, group 1 (n = 17) received 10 mg intravenous metoclopramide, and group 2 (n = 15) received an intravenous saline placebo.
Results:
No differences were found between groups in the time from spinal placement to the time of pain onset, the amount of morphine necessary to initially achieve comfort, or 24-hour postoperative morphine requirements. (P > .05).
Conclusions:
This study demonstrates that metoclopramide decreases intraoperative nausea but does not supplement analgesia in patients undergoing elective cesarean delivery.