• A Thune, L Appelgren, and E Haglind.
• Department of Surgery, Sahlgrenska Hospital, Gothenburg, Sweden.
• Eur J Surg. 1995 Apr 1;161(4):265-8.

ObjectiveTo compare the antiemetic effects of metoclopramide and hyoscine in patients after laparoscopic cholecystectomy.DesignProspective, randomised trial.SettingUniversity hospital, Sweden.Subjects100 consecutive patients median age 49 years (range 21-79) of whom 9 were withdrawn after randomisation.InterventionsPatients were randomised to receive either four doses of metoclopramide 10 mg intravenously starting at the induction of anaesthesia (n = 44), or hyoscine transdermally through a patch placed behind the ear at 0600 h on the day of operation (n = 47).Main Outcome MeasuresThe incidence of nausea and vomiting.ResultsMetoclopramide was significantly more effective at preventing both nausea and vomiting (20/44 (45%) compared with 32/47 (68%), p < 0.05, and 10/44 (23%) compared with 21/47 (45%), p < 0.05). Women were significantly more likely to become nauseated than men (46/66 (70%) compared with 5/25 (20%), p < 0.001). Two patients in the metoclopramide group developed dizziness, and one patient in the hyoscine group had a disturbance of vision. About 20% in each group required additional antiemetic treatment. The median hospital stay in both groups for patients who did not develop complications was 2 days.ConclusionThere was a high incidence of nausea and vomiting after laparoscopic cholecystectomy even after treatment with metoclopramide. Further measures are indicated, particularly for women.

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