- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT07638527
Time to First Rescue Antiemetic With Ondansetron Plus Metoclopramide Versus Dexamethasone Plus Metoclopramide for PONV Prophylaxis in Laparoscopic Cholecystectomy
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
연구 개요
상태
연구 유형
등록 (추정된)
단계
- 4단계
연락처 및 위치
연구 연락처
- 이름: Asifa Saeed, MBBS; FCPS
- 전화번호: +923006694460
- 이메일: drasifasaeed@gmail.com
연구 연락처 백업
- 이름: Huda Ather, MBBS
- 전화번호: +923047922909
- 이메일: atherhudaather@gmail.com
연구 장소
-
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Punjab Province
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Faisalābad, Punjab Province, 파키스탄, 38000
- 모병
- Faisalabad Medical University
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연락하다:
- Asifa Saeed, MBBS; FCPS
- 전화번호: +923006694460
- 이메일: drasifasaeed@gmail.com
-
연락하다:
- Huda Ather, MBBS
- 전화번호: +923047922909
- 이메일: atherhudaather@gmail.com
-
수석 연구원:
- Asifa Saeed, MBBS; FCPS
-
부수사관:
- Huda Ather, MBBS
-
부수사관:
- M. Ibtisam Ahmad, MBBS
-
-
참여기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
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
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 방지
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 삼루타
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: Group A (Ondansetron and Metoclopramide)- Separate syringes
Participants receive
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Ondansetron 4 mg IV administered as a single colorless syringe 5-10 minutes before induction of anesthesia for prevention of postoperative nausea and vomiting.
다른 이름들:
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.
다른 이름들:
|
|
활성 비교기: Group B (Dexamethasone and Metoclopramide)- Separate syringes
Participants receive
|
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.
다른 이름들:
Dexamethasone 8 mg IV administered as a single colorless syringe 5-10 minutes before induction of anesthesia for prevention of postoperative nausea and vomiting.
다른 이름들:
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Time to First Rescue Antiemetic (in minutes)
기간: 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)
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Number of Rescue Doses Required
기간: First 24 hours after surgery
|
Total number of rescue antiemetic (metoclopramide 10 mg IV) doses administered to each patient within the first 24 hours.
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First 24 hours after surgery
|
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Incidence of PONV
기간: 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
|
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Severity of Postoperative Nausea and Vomiting (RINVR Score)
기간: 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
|
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Patient Satisfaction with Antiemetic Treatment
기간: At hospital discharge (approximately 24 hours post-surgery)
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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)
|
기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Adverse Events
기간: 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.
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From drug administration up to 24 hours post-surgery
|
공동 작업자 및 조사자
수사관
- 수석 연구원: Asifa Saeed, MBBS; FCPS, Faisalabad Medical University
간행물 및 유용한 링크
일반 간행물
- Apfel CC, Laara E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999 Sep;91(3):693-700. doi: 10.1097/00000542-199909000-00022.
- Zhong B. How to calculate sample size in randomized controlled trial? J Thorac Dis. 2009 Dec;1(1):51-4.
- Mishriky BM, Habib AS. Metoclopramide for nausea and vomiting prophylaxis during and after Caesarean delivery: a systematic review and meta-analysis. Br J Anaesth. 2012 Mar;108(3):374-83. doi: 10.1093/bja/aer509. Epub 2012 Feb 3.
- Weibel S, Rucker G, Eberhart LH, Pace NL, Hartl HM, Jordan OL, Mayer D, Riemer M, Schaefer MS, Raj D, Backhaus I, Helf A, Schlesinger T, Kienbaum P, Kranke P. Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis. Cochrane Database Syst Rev. 2020 Oct 19;10(10):CD012859. doi: 10.1002/14651858.CD012859.pub2.
- Alam, M. S., et al. (2025). Haloperidol Versus Dexmedetomidine As An Adjuvant to Ondansetron in Postoperative Nausea and Vomiting in Laparoscopic Cholecystectomy. Egyptian Journal of Surgery, 44(2), 456-463
- Abel UR, Jensen K, Karapanagiotou-Schenkel I, Kieser M. Some Issues of Sample Size Calculation for Time-to-Event Endpoints Using the Freedman and Schoenfeld Formulas. J Biopharm Stat. 2015;25(6):1285-311. doi: 10.1080/10543406.2014.1000546. Epub 2015 Jan 28.
- Naguib M, el Bakry AK, Khoshim MH, Channa AB, el Gammal M, el Gammal K, Elhattab YS, Attia M, Jaroudi R, Saddique A. Prophylactic antiemetic therapy with ondansetron, tropisetron, granisetron and metoclopramide in patients undergoing laparoscopic cholecystectomy: a randomized, double-blind comparison with placebo. Can J Anaesth. 1996 Mar;43(3):226-31. doi: 10.1007/BF03011739.
- Chattopadhyay S, Biswas A, SK Samim Ferdows, Bhowmik DK, Dey S, Bi B. Comparison of Ondansetron, Dexamethasone and Ondansetron Plus Dexamethasone For The Prevention of Post-operative Nausea and Vomiting after Laparoscopic Cholecystectomy. Indian Journal of Clinical Anaesthesia. 2025;3(3):459-463. Accessed April 6, 2026.
- Korkusuz M, Et T. Effect of perioperative restrictive and liberal fluid regimens on postoperative nausea-vomiting and quality of recovery in laparoscopic cholecystectomy. World J Gastrointest Surg. 2025 Oct 27;17(10):110543. doi: 10.4240/wjgs.v17.i10.110543.
- Si XY, Wu LP, Li XD, Li B, Zhou YM. Dexamethasone combined with other antiemetics for prophylaxis after laparoscopic cholecystectomy. Asian J Surg. 2015 Jan;38(1):21-7. doi: 10.1016/j.asjsur.2014.04.005. Epub 2014 Jun 15.
- Ko-Iam W, Sandhu T, Paiboonworachat S, Pongchairerks P, Junrungsee S, Chotirosniramit A, Chotirosniramit N, Chandacham K, Jirapongcharoenlap T. Metoclopramide, versus its combination with dexamethasone in the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy: a double-blind randomized controlled trial. J Med Assoc Thai. 2015 Mar;98(3):265-72.
- Gan TJ, Jin Z, Ayad S, Belani KG, Habib AS, Meyer TA, Urman RD, Andrew BY, Bergese SD, Chung F, Diemunsch P, Kovac AL, Candiotti K, Englesakis M, Grant MC, Hedrick TL, Huang H, Kranke P, Lloyd SJ, Manahan MA, Minkowitz HS, Philip BK, Phillips BJ, Simpson KD, Stever J. Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting: Executive Summary. Anesth Analg. 2025 Nov 14. doi: 10.1213/ANE.0000000000007816. Online ahead of print. No abstract available.
연구 기록 날짜
연구 주요 날짜
연구 시작 (추정된)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
- 수술 후 합병증
- 병리학적 과정
- 징후 및 증상, 소화기
- 구토
- 메스꺼움
- 병리학적 상태, 징후 및 증상
- 징후 및 증상
- 수술 후 메스꺼움 및 구토
- 황 화합물
- 유기 화학 물질
- 이종 사이 클릭 화합물, 1- 링
- 이종 사이 클릭 화합물
- 이종 사이 클릭 화합물, 2- 링
- 이종 사이 클릭 화합물, 융합 링
- Azoles
- 탄화수소
- 탄화수소, 순환
- 카르 복실 산
- 하이드 록시 산
- 탄화수소, 방향족
- 다 환식 화합물
- 이미 다졸
- 아미드
- 인돌
- Pretadienes
- 임신
- 스테로이드
- 융합 링 화합물
- 스테로이드, 불소
- 페놀
- 벤젠 유도체
- 설 폰산
- 황산
- Pregnadienetriols
- 산, 카르 보 사이 클릭
- 벤젠 설포 네이트
- 아릴 설포 네이트
- 아릴 설 폰산
- 파라-아미노 벤조이트
- 아미노벤조테스
- 벤조테스
- 하이드 록시 벤조이트
- 이종 사이 클릭 화합물, 3- 링
- 페닐 에테르
- 벤자 아미드
- 클로로 벤 조테스
- 카르 바질
- 하이드 록시 벤조이트 에테르
- 덱사메타손
- 온단세트론
- 메토클로프라미드
- 칼슘 도베실레이트
- 덱사메타손 아세테이트
기타 연구 ID 번호
- 48/ERC/FMU/2025-26/343
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
IPD 계획 설명
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
미국에서 제조되어 미국에서 수출되는 제품
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