Comparing Dexamethasone and Metoclopramide to Prevent Nausea and Vomiting After Cataract Surgery in Adults Aged 40 to 80

What this Trial Is About

Postoperative nausea and vomiting PONV frequently occur after ambulatory surgeries like cataract surgery, affecting up to 80% of high-risk patients and 20-30% overall. PONV can disrupt recovery, delay discharge, increase medical costs, and lower patient satisfaction. It may also lead to serious complications such as suprachoroidal hemorrhage SCH, a condition involving bleeding in the eye. This study evaluates whether dexamethasone can reduce PONV incidence compared to metoclopramide in adults undergoing cataract surgery. Participants are randomized into three groups one receiving 8 mg dexamethasone, another 10 mg metoclopramide, and a placebo group receiving saline. All patients receive sedation with midazolam, ketamine, and nalbuphine, along with a peribulbar block using lidocaine and bupivacaine. The study is double-blind and placebo-controlled, conducted at Alexandria University hospitals, with medication administered before sedation. Rescue antiemetic ondansetron and analgesic ketorolac drugs are available if needed. During the study, participants undergo preoperative evaluation including history, examination, and laboratory tests. Standard monitoring includes ECG, blood pressure, and oxygen saturation. Researchers assess nausea severity, vomiting incidence, pain scores, and use of rescue medications on the first postoperative day. The primary outcome is the number of patients experiencing nausea and vomiting post-surgery. Secondary outcomes include pain levels and side effects such as dizziness, itching, and headache. The study aims to improve management of PONV to enhance patient recovery and satisfaction.

Dexamethasone Versus Metoclopramide for Prophylaxis of Nausea and Vomiting After Cataract Surgery