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Time to First Rescue Antiemetic With Ondansetron Plus Metoclopramide Versus Dexamethasone Plus Metoclopramide for PONV Prophylaxis in Laparoscopic Cholecystectomy

9. juni 2026 opdateret af: Dr. Asifa Saeed, Faisalabad Medical University

Time-to-first-rescue Antiemetic With Ondansetron Plus Metoclopramide Versus Dexamethasone Plus Metoclopramide for PONV Prophylaxis in Laparoscopic Cholecystectomy: a Randomized, Triple-Blind, Superiority Trial

The goal of this superiority randomized controlled trial (RCT) is to learn if one dual-drug arm increases patient comfort (time to needing rescue medication for nausea/vomiting) more effectively than the other in adults with Moderate-to-High PONV risk (Apfel score 2-4) undergoing elective laparoscopic cholecystectomy (gallbladder surgery).

The main question this study aims to answer is:

• Does Ondansetron plus Metoclopramide prolong time to first rescue antiemetic more than Dexamethasone plus Metoclopramide?

Researchers will compare Group A (Ondansetron 4mg plus Metoclopramide 10mg IV) to Group B (Dexamethasone 8mg IV plus Metoclopramide 10mg IV) to see if Group A provides a longer time to first rescue medication.

Participants will:

  • Receive their assigned, blinded drug group 5-10 minutes before general anesthesia induction.
  • Receive rescue Metoclopramide 10mg IV if they experience any vomiting or severe nausea
  • Be monitored for 24 hours post-surgery in the hospital
  • Report nausea severity at 2, 6, 12 and 24 hours post-surgery

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

264

Fase

  • Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Pakistan
    • Punjab Province
      • Faisalābad, Punjab Province, Pakistan, 38000
        • Faisalabad Medical University
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Asifa Saeed, MBBS; FCPS
        • Underforsker:
          • Huda Ather, MBBS
        • Underforsker:
          • M. Ibtisam Ahmad, MBBS

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Age ≥ 18 years
  • American Society of Anesthesiologists (ASA) physical status I or II
  • Scheduled for elective laparoscopic cholecystectomy
  • Apfel score 2-4 (moderate to high risk for PONV)
  • Provides written informed consent prior to enrollment

Exclusion Criteria:

  • Known allergy or hypersensitivity to ondansetron, dexamethasone, or metoclopramide
  • Emergency surgery (e.g., acute cholecystitis, perforation, or gangrene)
  • Pregnancy or breastfeeding
  • ASA physical status III or IV
  • Preexisting hepatic impairment
  • Baseline corrected QT (QTc) interval > 420 ms on pre-operative ECG
  • History of dystonic reaction to metoclopramide or other dopamine antagonists
  • Preexisting renal impairment (e.g., serum creatinine > 1.5 mg/dL or on dialysis)
  • Unable or unwilling to provide informed consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Group A (Ondansetron and Metoclopramide)- Separate syringes

Participants receive

  • Ondansetron (4 mg IV) and
  • Metoclopramide (10 mg IV), in two separate colorless syringes, 5-10 minutes before the induction of general anesthesia.
Medicin: ondansetron 4 mg
Ondansetron 4 mg IV administered as a single colorless syringe 5-10 minutes before induction of anesthesia for prevention of postoperative nausea and vomiting.
Andre navne:
  • Zofran
  • Zophren
  • Onmax
Medicin: Metoclopramide 10mg
Metoclopramide 10 mg IV administered as a single colorless syringe 5-10 minutes before induction of anesthesia as part of dual-agent PONV prophylaxis. Also used as rescue antiemetic (10 mg IV) if patient has vomiting or VRS >4 for nausea.
Andre navne:
  • Maxolon
  • Reglan
  • Paspertin
Aktiv komparator: Group B (Dexamethasone and Metoclopramide)- Separate syringes

Participants receive

  • Dexamethasone 8mg IV and
  • Metoclopramide 10mg IV, in two separate colorless syringes, 5-10 minutes before the induction of general anesthesia.
Medicin: Metoclopramide 10mg
Metoclopramide 10 mg IV administered as a single colorless syringe 5-10 minutes before induction of anesthesia as part of dual-agent PONV prophylaxis. Also used as rescue antiemetic (10 mg IV) if patient has vomiting or VRS >4 for nausea.
Andre navne:
  • Maxolon
  • Reglan
  • Paspertin
Medicin: Dexamethasone (intravenous)
Dexamethasone 8 mg IV administered as a single colorless syringe 5-10 minutes before induction of anesthesia for prevention of postoperative nausea and vomiting.
Andre navne:
  • Dekadron
  • Fortecortin
  • Oradexon

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time to First Rescue Antiemetic (in minutes)
Tidsramme: First 24 hours after surgery (measured from the time of arrival to Post-anaesthesia care unit, PACU)
Time in minutes from patient arrival to Post-anaesthesia care unit, PACU (time zero) to administration of rescue metoclopramide 10 mg IV. Rescue is given if patient experiences any episode of vomiting/retching or reports a nausea Verbal Rating Scale (VRS) score >4. VRS scale is no nausea (0), mild (1-3), moderate (4-6), and severe (7-10).
First 24 hours after surgery (measured from the time of arrival to Post-anaesthesia care unit, PACU)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Rescue Doses Required
Tidsramme: First 24 hours after surgery
Total number of rescue antiemetic (metoclopramide 10 mg IV) doses administered to each patient within the first 24 hours.
First 24 hours after surgery
Incidence of PONV
Tidsramme: 24 hours post-surgery

Proportion of patients experiencing any nausea (VRS >1) or any vomiting/retching episode within the first 24 hours post-surgery.

Verbal Rating Scale (VRS) is a well established measurement scale with a total of 11 points where 0 = no nausea and 10 = worst possible nausea.
24 hours post-surgery
Severity of Postoperative Nausea and Vomiting (RINVR Score)
Tidsramme: Measured at 2, 6, 12, and 24 hours post-surgery
Measured using the Rhodes Index of Nausea, Vomiting, and Retching (RINVR). It evaluates 8 dimensions: frequency/duration/distress of nausea; frequency/amount/distress of vomiting; and frequency/distress of retching. Total score range is 0-32, with 0 indicating no nausea, 1-8 mild, 9-16 moderate, 17-24 severe, and 25-32 great nausea. The higher scores indicate worse PONV.
Measured at 2, 6, 12, and 24 hours post-surgery
Patient Satisfaction with Antiemetic Treatment
Tidsramme: At hospital discharge (approximately 24 hours post-surgery)

Patient-reported satisfaction measured on a 5-point Likert scale (Very Dissatisfied to Very Satisfied) at the end of hospital stay.

Likert scale is a 5-point psychometric survey scale, with 1 indicating very disappointing and 5 indicating very satisfying. The higher the score, the better the treatment was.
At hospital discharge (approximately 24 hours post-surgery)

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Adverse Events
Tidsramme: From drug administration up to 24 hours post-surgery
Proportion of patients experiencing any adverse reaction including allergic reaction, headache, perineal burning, dystonia, or QT prolongation on post-operative ECG.
From drug administration up to 24 hours post-surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Faisalabad Medical University

Efterforskere

  • Ledende efterforsker: Asifa Saeed, MBBS; FCPS, Faisalabad Medical University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Hjælpsomme links

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juli 2026

Primær færdiggørelse (Anslået)

1. februar 2027

Studieafslutning (Anslået)

1. april 2027

Datoer for studieregistrering

Først indsendt

4. juni 2026

Først indsendt, der opfyldte QC-kriterier

4. juni 2026

Først opslået (Faktiske)

10. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

11. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

9. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 48/ERC/FMU/2025-26/343

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Individual participant data will not be shared because the study is single-centre, small and unfunded. Only aggregated, de-identified, summary data will besshared

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