Metoclopramide Decreases Emesis After Spinal Anesthesia Supplemented With Subarachnoid Morphine

BACKGROUND AND OBJECTIVES: The authors studied whether metoclopramide decreases the incidence of emesis after spinal anesthesia supplemented with subarachnoid morphine. METHODS: Patients underwent total hip arthroplasty under spinal anesthesia using tetracaine with norepinephrine and morphine 0.2 mg. Forty-eight patients were included in the study conducted with a paired design, using sequential analysis. Patients were allocated randomly and double-blinded to the treatment with metoclopramide or to the control group. In one group, metoclopramide 20 mg intramuscularly was given before and after surgery; patients in the control group were given equal volumes of saline. The presence of emesis for 5 hours postoperatively was recorded. RESULTS: In the postoperative period, emesis was noted in 58% of control patients but in only 17% of patients given metoclopramide (P < .05). CONCLUSIONS: The data suggest that metoclopramide is effective against postoperative emesis after spinal anesthesia supplemented with subarachnoid morphine.