Prevention of Post-cesarean Nausea and vomiting by Intramuscular Metoclopramide: A Randomized Clinical trial

Background & aim: Nausea and vomiting are considered as the main post-cesarean complications in women undergoing cesarean section. Therefore, the present study aimed to examine the efficacy of intramuscular metoclopramide before cesarean section to prevent post-cesarean nausea and vomiting. Methods: Study population in the present study consisted of 617 women scheduled for cesarean section. The participants were randomly divided into intervention and control groups. The intervention group received 10 mg intramuscular metoclopramide prior to the surgery, compared to the control group taking an aquatic neutral placebo. Nausea, vomiting, feeling of hunger, and eating time were assessed postoperatively using a visual analog scale every 4 hour. Data were analyzed using the Chi-square test and t-test in SPSS software (version 17). Results: During 12-hour postoperative observation, the incidence and intensity of nausea were lower in the metoclopramide group (P=0.005). Metoclopramide group clearly needed a less severe therapeutic approach for nausea (14% vs. 44%). Furthermore, participants in the intervention group showed a decline in vomiting; however, this decline was not significant (P=0.4). The metoclopramide group developed the feeling of hunger and eating sooner than those in the control group (P=0.003, P=0.002, respectively). None of the participants reported any side effects of this medication. Conclusion: The intramuscular injection of 10 mg metoclopramide before cesarean section decreased the incidence and intensity of nausea as well as discharge time from the hospital. Metoclopramide is recommended as a safe, available, and inexpensive medication, which can result in a higher level of maternal health and shorter period of hospitalization.