Prophylactic Metoclopramide Research Articles

The efficacy of prophylactic metoclopramide in preventing nausea and vomiting in patients with acute pain treated with intravenous tramadol: a randomized double-blinded, placebo-controlled trial

ObjectiveTo examine the clinical efficacy of prophylactic metoclopramide in reducing the incidence of nausea and vomiting in emergency department (ED) patients with acute pain who were treated with intravenous tramadol.ResultsWe conducted a single-center randomized, double-blinded, placebo-controlled trial. A total of 99 ED patients presented with acute pain were recruited. Sixty-four patients were randomized, 31 patients in the treatment arm and 33 in the control arm. Overall, there were no significant differences in baseline characteristics between treatment arm and control arm. Only one patient within each arm reported having nausea symptom. No patients reported vomiting episode. There was no statistically significant difference in the proportion of patients with nausea or vomiting symptoms between the two groups (3.2% in the treatment arm vs. 3.0% in the control arm, p = 1.000). The administration of prophylactic metoclopramide may not provide additional benefit in reducing the occurrence of nausea and/or vomiting episode in ED patients with acute pain treated with intravenous tramadol.Trial registration Randomized clinical trial TCTR20220525001; registration date: 21 October 2021. Retrospectively registered.

Prophylactic antiemetics for adults receiving intravenous opioids in the acute care setting.

Physicians often prescribe opioids for pain in the acute care setting. Nausea and vomiting are well-described adverse events, occurring in over one-third of patients. Prophylactic antiemetics may be one option to reduce opioid-associated nausea and vomiting. However, these medications also have their own adverse effects, so it is important to understand their efficacy and safety prior to routine use. This is a review of randomized controlled trials comparing prophylactic antiemetics versus placebo or standard care for preventing opioid-associated nausea and vomiting. To assess the effects of prophylactic antiemetics for nausea and vomiting in adults (aged 16 years or older) receiving intravenous opioids in the acute care setting. We searched CENTRAL (the Cochrane Library), MEDLINE (OVID), Embase (OVID) from inception to January 2022, and Google Scholar (17 January 2022). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and screened reference lists. We included randomized controlled trials of prophylactic antiemetics versus placebo or standard care in adults prior to receiving an intravenous opioid. Two review authors (MG, JNC) independently determined the eligibility of each study according to the inclusion criteria. Two review authors (MG, GDP) then independently extracted data, assessed risk of bias, and determined the certainty of evidence using GRADE. Our primary outcomes were the occurrence of nausea, vomiting, and adverse events. Secondary outcomes included nausea severity, number of vomiting episodes, and number of participants requiring antiemetic rescue therapy. We presented outcomes as risk ratios (RR) for dichotomous data (e.g. presence of vomiting, presence of nausea, number of participants requiring rescue medication, adverse events) and mean difference (MD) or standardized mean difference for continuous data (e.g. number of vomiting episodes, nausea severity) with 95% confidence intervals (CI). We included three studies involving 527 participants (187 women and 340 men) with a mean age of 42 years. All studies used intravenous metoclopramide (10 mg) as the intervention and a placebo for the comparator. No studies assessed any other antiemetic or compared the intervention to standard care. Compared to placebo, metoclopramide did not reduce vomiting (RR 1.18, 95% CI 0.26 to 5.32; low-certainty evidence) or nausea (RR 0.55; 95% CI 0.15 to 2.03; low-certainty evidence) and there was no difference in adverse events (RR 2.34, 95% CI 0.47 to 11.61; low-certainty evidence). No data were available regarding the number of vomiting episodes. Metoclopramide did reduce the severity of nausea compared with placebo (MD -0.49, 95% CI -0.75 to -0.23; low-certainty evidence) but did not reduce the need for rescue medication (RR 1.86, 95% CI 0.17 to 20.16; low-certainty evidence). Two studies were at unclear risk of bias for random sequence generation, one for blinding of outcome assessors, one for incomplete outcome data, and two for selective reporting. The studies were at low risk of bias for all remaining components. There was no evidence that prophylactic metoclopramide affected the risk of vomiting, nausea, or the need for rescue medication when provided prior to intravenous opioids in the acute care setting. There was a clinically insignificant difference in nausea severity when comparing prophylactic metoclopramide with placebo.Overall, the evidence was of low certainty. Future research could better delineate the effects of prophylactic antiemetics on specific populations, and new studies are needed to evaluate the use of other prophylactic antiemetic agents, for which there were no data.

Evaluation of the Tolerability of Combination Chemotherapy with Mitoxantrone and Dacarbazine in Dogs with Lymphoma.

Combination chemotherapy can be an effective option for treating resistant lymphoma in dogs. This retrospective study examined the tolerability and efficacy of the combination of 5-(3,3-dimethyl-1-triazeno)-imidazole-4-carboxamide (dacarbazine) (DTIC) in a population of dogs with lymphoma resistant to a doxorubicin-containing chemotherapy protocol. Mitoxantrone was administered at 5 mg/m2 IV over 10 min followed by DTIC at 600 mg/m2 IV over 5 hr, every 3 wk. All dogs were treated with prophylactic trimethoprim-sulfadiazine and metoclopramide. The frequency of grade 4 neutropenia was 18%, and 5% of dogs were hospitalized from sepsis. Gastrointestinal toxicity was uncommon. The overall response rate was 34% (15 of 44; 95% confidence interval 20-48%) for a median duration of 97 days (range 24-636 days, 95% confidence interval 44-150 days). Fourteen of 15 dogs who received mitoxantrone and DTIC as first rescue responded to treatment. Dogs who achieved complete remission to their initial L-asparaginase, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy protocol were more likely to respond to mitoxantrone and DTIC (23 versus 11%, P = .035). The combination of mitoxantrone and DTIC is a safe treatment option for resistant lymphoma in dogs.

Prophylactic metoclopramide use in trauma patients given tramadol: A randomised, double-blinded, placebo-controlled trial

Background: Tramadol is a common analgesia used in Emergency Department for trauma patients. However, it causes multiple side effects, most notably nausea and vomiting. Objectives: The aim of this study is to determine whether routine administration of prophylactic metoclopramide in patients receiving intravenous tramadol for injuries of extremities is beneficial. Method: A randomised, double-blinded, placebo-controlled trial was carried out on 200 trauma patients requiring tramadol for acute pain in Emergency & Trauma Department of Sarawak General Hospital. Patients were randomised into two groups, group one received metoclopramide 10 mg intravenously while group two received placebo. Nausea severity (measured on a visual analogue scale) before and after tramadol administration, number of episodes of vomiting and patients’ demographic data were recorded. Results: A total of 191 patients were recruited, in which the metoclopramide group had 96 patients while the placebo group had 95 patients. In total, 5 out of 191 patients had significant worsening of nausea severity and all were from the placebo group (5.26%). The difference was statistically significant (p = 0.029, Fisher’s exact test). Only 1 out of 191 patients vomited and was from the placebo group. No adverse reaction was reported in both groups of patients. Conclusion: Routine administration of intravenous metoclopramide may be beneficial in musculoskeletal trauma patients receiving tramadol.

Effectiveness of Intravenous Metoclopramide Prophylaxis on the Reduction of Intraoperative and Early Postoperative Nausea and Vomiting after Emergency Caesarean Section under Spinal Anaesthesia

Background: Nausea and vomiting is a common problem after spinal anaesthesia after cesarean section. Metoclopramide is reported to be effective in reducing the incidence and severity of nausea and vomiting (NV). However, its effectiveness as monotherapy remains unexplored. Aims: We aimed to assess the effectiveness of metoclopramide prophylaxis on the prevention of nausea and vomiting after emergency cesarean section under spinal anaesthesia. Methods and material: A prospective non-controlled study was conducted at a referral hospital. Patients classified as metoclopramide group who received 10 mg IV prophylaxis versus no prophylaxis group. Pre-tested checklist and patient interview were employed to collect the data during operation, at 2 h, 4 h and 6 h after cesarean section. Student’s t-test or Mann-Whitney U tests were used to compare the incidence and severity of nausea and vomiting between the groups. Chi-square and Fisher exact tests were used to compare the proportion of categorical variables between the groups. Results: The overall incidence of intraoperative and early postoperative nausea and vomiting were 25.8% and 48.5% in the treatment (n=66) group and non-treatment (n=66) group respectively. Prophylactic metoclopramide significantly reduced the overall incidence of intraoperative and early postoperative nausea and vomiting (25.8% vs. 48.5%, p=0.012) compared with non-treatment group. The median score for nausea on numeric rating scale was also reduced in the prophylaxis at the end of CS, 2 h and at 4 h after CS. Conclusion: The incidences of nausea and vomiting were high. The administration of prophylactic metoclopramide remarkably reduced the incidence and severity of intraoperative and early postoperative nausea and vomiting compared to the non-treatment group. We recommend metoclopramide prophylaxis for parturients undergoing emergency cesarean section under spinal anaesthesia. In addition, preoperative risk stratification strategies and perioperative nausea and vomiting management protocols need to be established in the hospital.

Preoperative Use of 10-mg Metoclopramide and 50-mg Dimenhydrinate in the Prophylaxis of Postoperative Nausea and Vomiting in Elective Caesarean Births: A Prospective Randomized Clinical Study.

The purpose of this study was to assess the efficacy and outcomes of preoperative prophylactic metoclopramide and dimenhydrinate use in elective cesarean births. Participants (n=84) scheduled for elective cesarean births were randomized equally into placebo (10cc 0.9% NaCl), 10-mg metoclopramide or 50-mg dimenhydrinate groups. Oral alimentation was prohibited 8h before the surgery; however, patients continued drinking water until 4h before surgery. Placebo and antiemetics were administered 1h before the anticipated procedure in a 5-ml syringe. In metoclopramide and dimenhydrinate group, an ampoule of the agents was completed to 5ml by adding 0.9% NaCl. In the control group 5ml of 0.9% NaCl was used. All prophylactic agents were administered intramuscularly. All patients received a general anesthesia. The placebo group (control group) was compared with the metoclopramide and dimenhydrinate groups. Demographic data including maternal age, height, weight, body mass index, gravidity, parity, miscarriage, induced abortion, the number of offspring, and the medical history did not show significant differences among the three groups. Postoperative nausea, vomiting, and the use of rescue medication ratios were significantly lower in metoclopramide and dimenhydrinate groups compared with the placebo group (p<0.05); however, the difference between the metoclopramide and dimenhydrinate groups was not significant (p>0.05). Dimenhydrinate and metoclopramide significantly decrease postoperative nausea, vomiting, and the need for rescue antiemetic medication. Both agents have similar efficacy and may be used as an alternative to each other.

Stroke : Highlights of Selected Articles

HomeStrokeVol. 46, No. 2Stroke: Highlights of Selected Articles Free AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessResearch ArticlePDF/EPUBStroke: Highlights of Selected Articles Originally published1 Feb 2015https://doi.org/10.1161/STROKEAHA.114.008576Stroke. 2015;46:321Reliability and Limitations of Automated Arrhythmia Detection in Telemetric Monitoring After StrokeAll patients with acute ischemic stroke should have continuous ECG monitoring during admission to the hospital because of the increased risk of serious cardiac arrhythmia and for the detection of possible atrial fibrillation. Data on the use of continuous cardiac monitoring for patients with stroke are lacking. The current study by Kurka et al aimed to determine the validity of cardiac monitoring in a stroke unit after acute stroke. A total of 151 patients were included in the study, and >4800 hours of monitoring were evaluated. In total, 22 509 alarms were detected. Approximately 73% of all nonlife threatening alarms were correct. In contrast, only 8.6% of the 140 alarms deemed life-threatening arrhythmias were correct. Of these, asystole had the highest false-positive rate, as only 2% of these alarms were true asystole. In summary, continuous cardiac monitoring in acute stroke seems sensitive but not specific. The high false positivity can lead to noise disturbances and alarm fatigue. Further improvement in specificity of continuous cardiac monitoring is needed. See p 560.Bright Vessel Appearance on Arterial Spin Labeling MRI for Localizing Arterial Occlusion in Acute Ischemic StrokeArterial spin labeling (ASL) is a perfusion-weighted MRI sequence. The current study by Yoo et al reviewed the MRIs of 117 patients with acute ischemic stroke. All MRIs were analyzed for the presence or absence of bright vessel signal on ASL, susceptibility vessel sign, fluid-attenuated inversion recovery vascular hyperintensity, and arterial occlusion on MR angiography (MRA). The purpose of the study was to determine whether bright vessel signal on ASL could help localize arterial occlusion on MRI in patients with acute stroke. ASL bright vessel appearance was more common in patients with arterial occlusion seen on MRA than those without occlusion. The bright appearance on ASL was seen both proximal and distal to the site of occlusion. The sensitivity of ASL bright vessel appearance in detecting arterial occlusion was far more sensitive than susceptibility vessel sign when using MRA as a standard reference (94%, 33/35 versus 66%, 23/35; P=0.002). Among the 82 cases of negative MRA, ASL bright vessel appearance detected more peripheral occlusions than susceptibility vessel sign (21%, 17/82 versus 10%, 8/82; P=0.012). Importantly, this study showed that bright vessel signal on ASL may be helpful in identifying arterial occlusions not seen on MRA. Although further confirmatory studies are needed, the use of ASL in acute stroke MRI protocol may be helpful in diagnosing embolic lesions. See p 564.Safety and Effect of Metoclopramide to Prevent Pneumonia in Patients With Stroke Fed via Nasogastric Tubes TrialPneumonia is a major cause of morbidity and mortality after stroke. Dysphagia and aspiration are important causes of pneumonia after stroke. Patients receiving tube feeds via nasogastric tubes are at high risk of pneumonia. Metoclopramide, a dopamine antagonist, is both an antiemetic and gastric prokinetic. The authors hypothesized that the reduction in vomiting and reflux in patients on metoclopramide would lead to a reduction in the risk of aspiration and pneumonia. Metoclopramide to Prevent Pneumonia in Patients With Stroke Fed Via Nasogastric Tubes (MAPS) trial is a randomized, double blind, placebo-controlled trial of prophylactic metoclopramide versus placebo in patients with stroke fed via nasogastric tubes. Sixty patients were enrolled in this study in the 1:1 ratio. Pneumonia was significantly more common in the placebo group compared with the metoclopramide group (rate ratio, 5.24; P<0.001). There were also significantly more episodes of aspiration and days on antibiotics in the placebo group. There was no significant difference in mortality between both treatment groups. Extrapyramidal reactions, such as dystonic reactions and tardive dyskinesia, were not seen in the metoclopramide group. The results of the MAPS study show that the prophylactic use of metoclopramide in patients with stroke with nasogastric tubes is safe and reduces the incidence of pneumonia. Although these results are certainly promising, this study is limited by its size, and thus, larger studies will be needed before best determine the effect of metoclopramide in this stroke population. See p 454. Previous Back to top Next FiguresReferencesRelatedDetails February 2015Vol 46, Issue 2 Advertisement Article InformationMetrics © 2015 American Heart Association, Inc.https://doi.org/10.1161/STROKEAHA.114.008576 Originally publishedFebruary 1, 2015 PDF download Advertisement

Anti-emetic efficacy of prophylactic granisetron, droperidol and metoclopramide in the prevention of nausea and vomiting after laparoscopic cholecystectomy

Anti-emetic efficacy of prophylactic granisetron, droperidol and metoclopramide in the prevention of nausea and vomiting after laparoscopic cholecystectomy

Review article: Prophylactic metoclopramide for patients receiving intravenous morphine in the emergency setting: A systematic review and meta‐analysis of randomized controlled trials

The objective of the present study was to conduct a systematic review and meta-analysis of randomized controlled trials, comparing metoclopramide with placebo, for preventing vomiting in patients who have received i.v. morphine for acute pain in the emergency setting, and to determine the level of evidence supporting the use of prophylactic metoclopramide in this population. Comprehensive systematic electronic searches were conducted of MEDLINE, EMBASE and the Cochrane Library for randomized controlled trials addressing the clinical question. Reference lists of identified articles were hand-searched. Methodologically appropriate clinical trials identified in the search process were included in a meta-analysis to provide a pooled estimate of effect. Three randomized controlled trials fulfilled the search criteria. All three studies were included in the final meta-analysis that demonstrated an overall result of no difference between metoclopramide and placebo for the primary outcome of vomiting (odds ratios 0.72; 95% confidence intervals 0.11-4.58). There was little evidence that routine prophylactic administration of metoclopramide following the administration of i.v. morphine for acute pain management in the emergency setting is clinically beneficial. Routine metoclopramide administration might expose patients to a risk of harm which is not justifiable given a lack of evidence of benefit.

A phase I study of the nitroimidazole hypoxia marker SR4554 using 19F magnetic resonance spectroscopy

Background:SR4554 is a fluorine-containing 2-nitroimidazole, designed as a hypoxia marker detectable with 19F magnetic resonance spectroscopy (MRS). In an initial phase I study of SR4554, nausea/vomiting was found to be dose-limiting, and 1400 mg m−2 was established as MTD. Preliminary MRS studies demonstrated some evidence of 19F retention in tumour. In this study we investigated higher doses of SR4554 and intratumoral localisation of the 19F MRS signal.Methods:Patients had tumours ⩾3 cm in diameter and ⩽4 cm deep. Measurements were performed using 1H/19F surface coils and localised 19F MRS acquisition. SR4554 was administered at 1400 mg m−2, with subsequent increase to 2600 mg m−2 using prophylactic metoclopramide. Spectra were obtained immediately post infusion (MRS no. 1), at 16 h (MRS no. 2) and 20 h (MRS no. 3), based on the SR4554 half-life of 3.5 h determined from a previous study. 19Fluorine retention index (%) was defined as (MRS no. 2/MRS no. 1)*100.Results:A total of 26 patients enrolled at: 1400 (n=16), 1800 (n=1), 2200 (n=1) and 2600 mg m−2 (n=8). SR4554 was well tolerated and toxicities were all ⩽grade 1; mean plasma elimination half-life was 3.7±0.9 h. SR4554 signal was seen on both unlocalised and localised MRS no. 1 in all patients. Localised 19F signals were detected at MRS no. 2 in 5 out of 9 patients and 4 out of 5 patients at MRS no. 3. The mean retention index in tumour was 13.6 (range 0.6–43.7) compared with 4.1 (range 0.6–7.3) for plasma samples taken at the same times (P=0.001) suggesting 19F retention in tumour and, therefore, the presence of hypoxia.Conclusion:We have demonstrated the feasibility of using 19F MRS with SR4554 as a potential method of detecting hypoxia. Certain patients showed evidence of 19F retention in tumour, supporting further development of this technique for detection of tumour hypoxia.

Ramosetron for the Prevention of Nausea and Vomiting During 5-Fluorouracil-Based Chemoradiotherapy for Pancreatico-biliary Cancer

The aim of the study was to evaluate the role of ramosetron for the prevention of chemoradiotherapy-induced nausea and vomiting (CRINV) in patients receiving upper abdominal irradiation with concurrent 5-fluorouracil chemotherapy. Between November 2006 and April 2007, 25 patients with pancreatico-biliary cancer underwent adjuvant chemoradiotherapy. A total dose of 40 Gy was delivered using 2 Gy/fraction, 5 days a week, with 2 weeks of planned rest after 20 Gy. Concomitant 5-fluorouracil (500 mg/m(2)/day i.v. bolus) was administered for the first 3 days of each split course. During the first course of chemoradiotherapy, all patients had prophylactic metoclopramide before treatment and those refractory to metoclopramide received rescue medication with ondansetron. During the second course of chemoradiotherapy, prophylactic ramosetron was given to patients who were refractory to ondansetron. Response to antiemetics was scored in four tiers: none, no CRINV; mild, did not interfere with normal daily life; moderate, interfered with normal daily life and severe, patient bedridden because of CRINV. Fifty-six percent of the patients (14 of 25) had moderate CRINV despite metoclopramide, and received ondansetron. Ten patients who experienced moderate CRINV despite the ondansetron had prophylactic ramosetron, and 60% of the patients (6 of 10) had the symptom improved. Ramosetron proved to be an effective alternative for the control of CRINV during upper abdominal irradiation with concurrent 5-fluorouracil chemotherapy.

531. Comparison of Prophylactic Dimenhydrinate and Metoclopramide for Prevention of Nausea-Vomiting Caused by Intrathecal Opioids in Parturients Undergoing Caesarean Delivery

531. Comparison of Prophylactic Dimenhydrinate and Metoclopramide for Prevention of Nausea-Vomiting Caused by Intrathecal Opioids in Parturients Undergoing Caesarean Delivery

531: Comparison of Prophylactic Dimenhydrinate and Metoclopramide for Prevention of Nausea-Vomiting Caused by Intrathecal Opioids in Parturients Undergoing Caesarean Delivery

531: Comparison of Prophylactic Dimenhydrinate and Metoclopramide for Prevention of Nausea-Vomiting Caused by Intrathecal Opioids in Parturients Undergoing Caesarean Delivery

Comparison of Prophylactic Dimenhydrinate and Metoclopramide for Prevention of Nausea-Vomiting Caused by Intrathecal Opioids in Parturients Undergoing Caesarean Delivery

Comparison of Prophylactic Dimenhydrinate and Metoclopramide for Prevention of Nausea-Vomiting Caused by Intrathecal Opioids in Parturients Undergoing Caesarean Delivery

Prophylactic metoclopramide with intravenous opioid analgesia in the emergency department: Does this constitute quality use of medicines?

Prophylactic metoclopramide with intravenous opioid analgesia in the emergency department: Does this constitute quality use of medicines?

Use of a prophylactic antiemetic with morphine in acute pain: Randomised controlled trial

Objective: The aim of this study was to compare the incidence of nausea and vomiting in patients with acute pain treated with morphine along with prophylactic metoclopramide or placebo. Method: A randomised controlled trial was carried out on patients requiring morphine for acute pain in the emergency department (ED) setting. Children under the age of 12, patients who had been vomiting or had already received prehospital analgesia, and those unable to give consent were excluded. All patients were given either metoclopramide (10 mg) or placebo (normal saline) followed by intravenous morphine. Pain scores (measured on a visual analogue scale) before and after morphine administration, all incidents of nausea or vomiting, the dose of morphine, and the patients’ demographic data were recorded. Fisher’s exact test was used for comparing the two groups of patients. Results: A total of 259 patients were recruited. There were 123 patients in the metoclopramide group (age range 15–94 years; median age 53) and 136 patients in the placebo group (age range 17–93 years; median age 52.5). The overall incidence of nausea and vomiting in the whole study population was 2.7%, (1.6% in the metoclopramide group and 3.7% in the placebo group). The difference between the two groups was not statistically significant (Fisher’s exact test = 0.451; p = 0.3; z-test statistic = 1.02; 95% CI –6% to 2%). Conclusion: When intravenous morphine is administered for acute pain, the overall incidence of nausea and vomiting is low, regardless of whether these patients are given prophylactic metoclopramide or not.

Prophylactic Metoclopramide Does Not Prevent Morphine-Induced Nausea

Nausea and vomiting are well-known side effects of opioid medications. Concurrent prophylactic administration of antiemetics is standard practice, but

Use of a prophylactic antiemetic with morphine in acute pain: randomised controlled trial

Objective: The aim of this study was to compare the incidence of nausea and vomiting in patients with acute pain treated with morphine along with prophylactic metoclopramide or placebo. Method:...

The Effects of Prophylactic Metoclopramide and Induction with Propofol on Postoperative Nausea and Vomiting

Background: Postoperative nausea and vomiting (PONV) are common problems in patients undergoing a laparoscopic cholecystectomy. This study evaluated the effect of prophylactic metoclopramide (MCP) and induction with propofol on PONV. Methods: 165 patients undergoing laparoscopic cholecystectomy were randomly divided into four groups. Groups 1 (control group) and 2 were inducted with thiopental sodium. Groups 3 (propofol group) and 4 were inducted with propofol. Prophylactic metoclopramide 10 mg i.v. was administered in Groups 2 (MCP group) and 4 (propofol + MCP group). The incidence of PONV, the need for rescue antiemetics, adverse events, and the nausea severity scores were assessed at 0 to 1 hour and at 1 to 24 hours postoperatively. Results: During the first 24 hours after anesthesia, the incidence of PONV in Groups 1, 2, 3 and 4 was 41.5%, 29.3%, 30.3% and 23.3%, respectively. There was no significant difference between the groups. During the period, 1 hour to 24 hours, after anesthesia, the incidence of PONV in Groups 1, 2, 3 and 4 was 36.6%, 17.4%, 27.5% and 14.4%, respectively. The incidence of PONV in Group 4 was significantly lower than in Group 1 (P

Prophylactic Metoclopramide for Opioid Induced Nausea and Vomiting following Treatment of Acute Pain in the Prehospital Setting

Opioids are highly effective analgesics often administered for the emergency treatment of acute pain. When administered for acute pain, analgesics aide in patient management by improving tolerance of, and compliance with, therapeutic manoeuvres such as extrications from car wreckage, administration of oxygen, and application of splints. Prophylactic administration of metoclopramide for patients receiving opioid pain relief may reduce the incidence of nausea and vomiting in the ambulance.