Morinda Citrifolia Linn. for Prevention of Postoperative Nausea and Vomiting
Sunisa Prapaitrakool MD, FRCAT*, Arunporn Itharat PhD**
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand ** Department of Thai Traditional Medicine, Faculty of Medicine, Thammasat University,Pathumthani, Thailand
Objective : To be a a preliminary, prospective, randomized, double blinded, placebo-controlled trial to evaluate the efficacy of
Morinda citrifolia Linn or noni for the prevention of postoperative nausea and vomiting (PONV) in patients considered high
risk for PONV after various types of surgery.
Material and Method:The plant extract was prepared by boiling of dried noni fruit (maturity stage 3-4) then evaporated
under standard procedure and processed into capsules. The doses were 150mg, 300 mg and 600 mg which are equivalent to
5, 10 and 20 g of dried noni fruit, respectively. One hundred patients of ASA physical status I or II, aged 18-65 years, and
considered at risk for PONV, were randomized to receive 150, 300, 600 mg of noni extract or a placebo orally 1 hours before
surgery. Standard general anesthetic technique and postoperative analgesia were employed.
Results : Significantly fewer patients who had received the 600 mg noni extract experienced nausea during the first 6 hours
compared to the placebo group (48% for the 600mg noni group and 80% for the placebo group, p-value = 0.04). The
incidence of PONV in other time periods was not statistically different for all three noni doses compared to the placebo group.
No side effects were reported in all groups.
Conclusion : Morinda citrifolia Linn. has an antiemetic property and prophylactic noni extract at 600 mg (equivalent to 20g
of dried noni fruit or scopoletin 8.712 μg) effectively reduces the incidence of early postoperative nausea (0-6 hours).
Keywords : Morinda citrifolia , Noni, Antiemetics, Emesis, Thai Traditional Medicine, Anesthesia
