title: Pretreatment of patients requiring oral contrast abdominal computed tomography with antiemetics: a randomized controlled trial of efficacy.
abstract: OBJECTIVE
  Ingestion of diatrizoate meglumine before abdominal computed tomography (CT) is time consuming. We hypothesized that pretreatment with metoclopramide or ondansetron would result in faster ingestion of diatrizoate meglumine than placebo.
  
  
  METHODS
  The study was a double-blind, randomized controlled trial on adults requiring oral contrast abdominal CT. Patients were randomized to placebo, metoclopramide 10 mg, or ondansetron 4 mg intravenously 15 minutes before ingesting 2 L of diatrizoate meglumine. The primary outcome was time to complete diatrizoate meglumine ingestion. Secondary outcome measures included volume of diatrizoate meglumine ingested, 100-mm visual analog scale for nausea at 15-minute intervals, time to CT, vomiting, and use of rescue antiemetics. The study was powered to detect a 60-minute difference in diatrizoate meglumine ingestion time between saline and medication groups.
  
  
  RESULTS
  One hundred six patients were randomized; placebo (36), metoclopramide (35), and ondansetron (35). Groups were similar in baseline characteristics. Median (interquartile range) times for diatrizoate meglumine ingestion were placebo 109 minutes (82 to 135 minutes); metoclopramide 105 minutes (75 to 135 minutes); and ondansetron 110 minutes (79 to 140 minutes) (P=.67). Vomiting was less frequent with metoclopramide (3%) than placebo (18%) or ondansetron (9%) (P=.11). The visual analog scale for nausea at each point was not significantly different between groups (P=.11). The need for rescue antiemetics was lowest for metoclopramide (3%) compared with placebo (27%) and ondansetron (12%) (P=.02).
  
  
  CONCLUSIONS
  Pretreatment with ondansetron or metoclopramide does not reduce oral contrast solution ingestion time.
authors.affiliation: Department of Emergency Medicine, Stony Brook University Medical Center, Stony Brook, NY 11784-8350, USA. Gregory.garra@stonybrook.edu
authors.forename: Gregory
authors.initials: G
authors.lastname: Garra
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Singer
authors.forename: Danny
authors.initials: D
authors.lastname: Bamber
authors.forename: Jasmine
authors.initials: J
authors.lastname: Chohan
authors.forename: Regina
authors.initials: R
authors.lastname: Troxell
authors.forename: Henry C
authors.initials: HC
authors.lastname: Thode
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000704:Analysis of Variance; D000932:Antiemetics / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D003974:Diatrizoate Meglumine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control; D017294:Ondansetron / Q000008:administration & dosage*; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D003287:Contrast Media; D003974:Diatrizoate Meglumine; D017294:Ondansetron; D008787:Metoclopramide