Comparison of the Efficacy of Ketamine-Metoclopramide and Acetaminophen-Metoclopramide Combinations on Pain Intensity After Deep Vitrectomy Surgery

Abstract

Background: Deep vitrectomy is a specialized ophthalmic surgery, and due to its invasive nature, effective postoperative pain management is of significant importance. The aim of this study was to compare the preemptive effect of two drug combinations, ketamine–metoclopramide and acetaminophen–metoclopramide, on pain intensity following deep vitrectomy and to evaluate patients’ need for analgesic medication. Methods: In a randomized clinical trial, 120 patients scheduled for deep vitrectomy were allocated into three groups. Post-surgery, patients received one of the studied drug combinations or standard care (control group). Pain intensity was recorded using the VAS scale at specific time intervals. Demographic data, hemodynamic parameters, recovery duration, and patient satisfaction were also documented. Data were analyzed using Chi-square tests, one-way ANOVA, and repeated measures ANOVA. A P value less than 0.05 was considered statistically significant. Findings: There were no significant differences among the three groups regarding age, sex, BMI, hemodynamic status, and patient satisfaction. The mean post-operative pain intensity was significantly lower in the ketamine– metoclopramide group compared to the other two groups. Furthermore, the requirement for supplemental analgesics showed a notable decrease in this group. Conclusion: The use of the ketamine–metoclopramide combination can be considered an effective choice for short-term pain relief after deep vitrectomy, demonstrating superior performance in reducing pain intensity and the need for analgesics compared to the acetaminophen–metoclopramide combination and standard care. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.