Metoclopramide for Preventing Ileus after Benign Gynecologic Surgery: A randomized controlled trial
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Abstract
Objective: To assess the efficacy of metoclopramide for preventing ileus after benign gynecologic surgery
Materials and Methods: The included participants were diagnosed with benign gynecologic conditions and scheduled for abdominal hysterectomy at Khon Kaen Hospital between October 2021 and May 2022. The participants were randomly allocated into two groups: the metoclopramide group (n=25) received an injection of 2 ml (10 mg) of intramuscular metoclopramide, while the control group (n=25) received an injection of 2 ml of intramuscular normal saline at 2 h after surgery.
Results: The metoclopramide group had significantly less time to first passage of flatus than the control (placebo) group (1,785.3 ± 125.7 vs. 2,186.3 ± 103.0 min, mean difference 401.0 min (95% CI 73.1 to 728.9, p=0.02)). The incidence of ileus symptoms was significantly less in the metoclopramide group than in the control group (28% vs. 68%, p<0.01). Although not statistically significant, the metoclopramide group compared to the control group experienced (a) a shorter time to first defecation and time to tolerate a solid diet, (b) less need for additional antiemetics and additional analgesics, and (c) a shorter length of hospital stay. There were no adverse effects related to the use of metoclopramide in this study.
Conclusion: Postoperative intramuscular metoclopramide enhanced the recovery of bowel function after benign gynecologic surgery.
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