A DOUBLE-BLIND, PLACEBO-CONTROLLED EVALUATION OF INTRANASAL METOCLOPRAMIDE IN THE PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING

Nausea and vomiting are common complaints in the postoperative period and contribute to patient distress and delay of discharge for outpatie nt surgical procedures. Laparoscopic procedures are associated with a high incidence of postoperative nausea and vomiting (PONV) episodes. P arenteral use of metoclopramide prevents and treats PONV. The intranas al route provides rapid and complete absorption of metoclopramide with out many of the adverse effects observed with parenteral administratio n of the drug. We performed a prospective, double-blinded, randomized, placebo-controlled study to evaluate the safety and efficacy of metoc lopramide 20 mg administered intranasally for emetic prophylaxis in la paroscopic surgery patients. The results from 109 patients enrolled in the study showed that this intranasal dose of metoclopramide may be i neffective in preventing the occurrence of PONV: The poor performance of the intranasal metoclopramide formulation in this study cannot be a ttributed to patient-specific and perioperative factors. It may be due to an inadequate dose or slow absorption of the drug. The small sampl e size, however, may also have been a factor.