Postoperative nausea and vomiting: Comparison of the effect of postoperative meperidine or morphine in gynecologic surgery patients

Study Objective: To evaluate the incidence and severity of postoperative nausea and vomiting in women receiving postoperative intravenous morphine or meperidine following gynecologic surgery. Design: Prospective, double-blind, randomized study. Setting: Tertiary-care academic medical center. Patients: 200 ASA physical status I, II, and III patients scheduled for elective gynecologic surgery. Interventions: Patients received either postoperative IV morphine (n = 100) or meperidine (n = 100) following gynecologic surgery. Measurements: We compared pain scores, sedation scores, nausea scores, well-being scores, vomiting rate, and patient satisfaction in both groups 15, 30, 60, and 120 minutes after arrival in the postoperative anesthesia care unit. Main Results: The vomiting rate was 8/100 versus 7/100 (at 15 min), 4/100 versus 26/100 (at 30 min) (p < 0.05), 3/100 versus 23/100 (at 60 min) (p < 0.05), and 0/100 versus 0/100 (at 120 min) in the morphine or meperidine groups, respectively. The pain and sedation scores were similar in both groups. No major complications were noted in either group. Conclusion: Our study demonstrates an advantage of the use of morphine rather than meperidine for pain control in the immediate postoperative period following gynecologic surgery.