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

BMC Res Notes. 2023 Jul 27;16(1):158. doi: 10.1186/s13104-023-06395-y.

Abstract

Objective: To 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.

Results: We 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.

Keywords: Analgesics opioid; Metoclopramide; Opioid induce nausea and vomiting; Randomized controlled trial; Tramadol.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Pain* / drug therapy
  • Acute Pain* / prevention & control
  • Analgesics, Opioid / adverse effects
  • Antiemetics* / therapeutic use
  • Double-Blind Method
  • Humans
  • Metoclopramide / therapeutic use
  • Nausea / drug therapy
  • Nausea / prevention & control
  • Tramadol* / adverse effects
  • Tramadol* / therapeutic use
  • Vomiting / prevention & control

Substances

  • Metoclopramide
  • Tramadol
  • Antiemetics
  • Analgesics, Opioid