Prevention of Postoperative Nausea and Vomiting in Early Recovery: A Comparative Study of Ondansetron and Metoclopramide in Adults Undergoing Elective Lower Abdominal Surgery

Postoperative nausea and vomiting (PONV) remain common complications following surgery, despite the availability of various prophylactic antiemetic agents. This study aimed to compare the effectiveness of ondansetron and metoclopramide in preventing PONV in patients undergoing elective lower abdominal surgery under general anesthesia. In this double-blind, randomized controlled trial, 80 adult patients were equally allocated into two groups: one receiving 0.1 mg/kg of intravenous ondansetron and the other 0.2 mg/kg of intravenous metoclopramide at the end of surgery. The incidence, frequency, and need for rescue antiemetics were evaluated over 24 hours postoperatively. The overall incidence of nausea was higher in the ondansetron group (65%) compared to the metoclopramide group (52.5%), though not statistically significant (p = 0.071). Conversely, ondansetron was associated with a lower incidence of vomiting (47.2% vs. 52.8%) and significantly reduced need for rescue antiemetic therapy (38.1% vs. 61.9%, p = 0.023). Age group analysis revealed significantly higher PONV incidence among patients aged 20–39 years (p < 0.001). Gender and BMI were not predictive of nausea or vomiting occurrence but were associated with symptom recurrence. Although both agents were effective for PONV prophylaxis, ondansetron demonstrated clinical advantages by reducing vomiting frequency and the need for rescue therapy. Younger age was identified as a significant risk factor for PONV. These findings support the preferential use of ondansetron, particularly in high-risk patients, and emphasize the value of individualized prophylactic strategies.