The Effect of Adding Ondansetron and Metoclopramide to Intravenous Acetaminophen on Pain Control and Post-operative Nausea and Vomiting: A Randomized Double-blind Clinical Trial

Background: Pain and postoperative nausea and vomiting (PONV) are two common complications of laparoscopic cholecystectomy, highlighting the particular importance of increasing satisfaction among patients undergoing this surgery. Aim: This study was performed aimed to evaluate the effect of adding ondansetron and metoclopramide to intravenous acetaminophen on pain control and postoperative nausea and vomiting of patients undergoing laparoscopic cholecystectomy. Method: This double-blind clinical trial study was conducted in 2019 on 83 patients in the central operating room of Ghaem Hospital in Mashhad, Iran. The patients were randomly assigned to three groups. The first and second groups received intravenous acetaminophen with ondansetron at doses of 4 and 8 mg, respectively, and the third group received intravenous acetaminophen with metoclopramide. Pain and PONV scores were measured postoperatively. Data were analyzed by SPSS (version 25.0) and GEE model, Chi-square, ANOVA and Kruskal-Wallis tests. P 0.05 was considered statistically significant. Results: Patients in the first and second groups experienced more pain than those in the third group at the time of entering the recovery, leaving the recovery, and 6 h after the surgery (P 0.001). However, the PONV scores were not significantly different among the three groups (P=0.812). Implications for Practice: The co-administration of metoclopramide and acetaminophen was more effective than acetaminophen and ondansetron in controlling postoperative pain of laparoscopic cholecystectomy