Previous evidence suggested that 10 mg systemic
metoclopramide is not effective to prevent
postoperative nausea and/or
vomiting (
PONV) in patients receiving general anaesthesia. However, the evidence included data with questioned validity by the author Yoshitaka Fujii. The objective of the current study was to examine the effect of a systemic dose of 10 mg
metoclopramide to prevent
PONV. This quantitative systematic review was performed according to the
PRISMA guidelines. A wide search was performed to identify randomized clinical trials that evaluated systemic 10 mg
metoclopramide as a prophylactic agent to reduce
PONV. Meta-analysis was performed using a random-effect model. Thirty trials evaluating the effect of 10 mg systemic
metoclopramide in 3328 subjects on
PONV outcomes were included.
Metoclopramide reduced the incidence of 24 h
PONV compared with control, odds ratio (OR) [95% confidence interval (CI)] of 0.58 (0.43-0.78), number needed to treat (NNT)=7.8. When evaluated as separate outcomes,
metoclopramide also decreased the incidence of
nausea over 24 h, OR (95% CI) of 0.51 (0.38-0.68), NNT=7.1, and
vomiting over 24 h, OR (95% CI) of 0.51 (0.40-0.66), NNT=8.3. A post hoc analysis examining three studies with questioned validity performed by the author Yoshitaka Fujii that would meet criteria for inclusion in the current study did not demonstrate a significant benefit of
metoclopramide compared with control on the incidence of 24 h
PONV. Our findings suggest that
metoclopramide 10 mg i.v. is effective to prevent
PONV in patients having
surgical procedures under general anaesthesia.
Metoclopramide seems to be a reasonable agent to prevent
PONV.