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 receivi...

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Bibliographic Details
Published in:Hong Kong journal of emergency medicine 2019-03, Vol.26 (2), p.98-105
Main Authors: Choo, Kim Hoon, Manikam, Rishya A/L, Yoong, Khadijah Poh Yuen, Kandasamy, Vanitha A/P
Format: Article
Language:English
Subjects:
Antiemetic
Antiemetics
Clinical trials
metoclopramide
Nausea
Patients
Placebos (Medicine)
Psychic trauma
Testing
Therapeutic use
tramadol
Trauma
Trauma centers
Treatment
Vomiting
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Summary: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 and 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.
ISSN:1024-9079
2309-5407
DOI:10.1177/1024907918789586