Metoclopramide does not influence the frequency of propofol-induced spontaneous movements.
OBJECTIVE
To evaluate the effects of metoclopramide on the frequency and severity of propofol-induced movements.


METHODS
Randomized, double blind, placebo-controlled trial.


METHODS
Veterans Administration Medical Center.


METHODS
One hundred thirty-seven consenting adults scheduled to receive general anesthesia with propofol induction.


METHODS
Patients were randomized to receive either metoclopramide 10 mg intravenously (IV) or placebo (saline) 3 min before induction of general anesthesia. All patients received midazolam 1 to 2 mg IV, fentanyl 50 to 150 microg IV, and lidocaine 50 to 80 mg IV before induction of anesthesia.


METHODS
Occurrence of spontaneous movements and severity during the observation period were recorded after propofol induction by observing movement in the hands/arms and feet/legs, as well as presence of a hiccup. The dosage of anesthetic medications administered was also recorded for each patient.


RESULTS
No differences were noted in the frequency and severity of spontaneous movement in the patients who had received metoclopramide and placebo. However, compared with the patients who did not move, patients who experienced movements received a significantly higher dose of propofol (P = 0.025) and a lower dose of fentanyl (P = 0.049).


CONCLUSIONS
Metoclopramide does not affect the frequency of propofol-induced movements, but propofol and fentanyl doses influence the frequency of movements during propofol induction.
Department of Anesthesiology and Pain Management Service, Dallas Veterans Affairs Medical Center, Dallas, TX 75216, USA. fima.lenkovsky@va.gov
Fima
F
Lenkovsky
Brian D
BD
Robertson
Chandramouli
C
Iyer
Larry
L
Ross
Syed A
SA
Ahmed
Luis
L
Herazo
Vladislav
V
Markin
Girish P
GP
Joshi
D000368:Aged; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D005283:Fentanyl; D006606:Hiccup / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects / Q000627:therapeutic use*; D008874:Midazolam; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced* / Q000517:prevention & control*; D015742:Propofol / Q000009:adverse effects*; D018401:Sample Size
D018686:Anesthetics, Intravenous; D000932:Antiemetics; D006993:Hypnotics and Sedatives; D008787:Metoclopramide; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol