title: Slow infusion metoclopramide does not affect the improvement rate of nausea while reducing akathisia and sedation incidence.
abstract: OBJECTIVE
  To compare the effects of metoclopramide infusion in emergency department (ED) patients complaining of nausea to determine the changes in its therapeutic effect and prevention of side effects such as akathisia and sedation.
  
  
  METHODS
  A prospective, randomised, double blind trial, from 1 March 2007 to 1 May 2008 in the ED of Pamukkale University Faculty of Medicine. Patients with moderate to severe nausea were randomised and divided into two groups: group 1 received 10 mg metoclopramide as a slow intravenous infusion over 15 min plus placebo (SIG); group 2 received 10 mg metoclopramide as an intravenous bolus infusion over 2 min plus placebo (BIG). The whole procedure was observed, and nausea scores, akathisia and vital changes were recorded.
  
  
  RESULTS
  140 patients suffering from moderate to severe nausea in the ED were included in the study. There was no significant difference between the groups in terms of mean nausea scores during follow-up (p=0.97). A significant difference in akathisia incidence was observed between the groups (18 (26.1%) in the BIG and 5 (7%) in the SIG) (p=0.002). There was also a significant difference in sedation incidence between the groups (19 (27.5%) in the BIG and 10 (14.5%) in the SIG) (p=0.05).
  
  
  CONCLUSIONS
  Even though slowing the rate of infusion of metoclopramide does not affect the rate of improvement in nausea, it may be an effective strategy for reducing the incidence of akathisia and sedation in patients with nausea.
authors.affiliation: Medical Faculty, Department of Emergency Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Tura
authors.forename: Bulent
authors.initials: B
authors.lastname: Erdur
authors.forename: Berrin
authors.initials: B
authors.lastname: Aydin
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Turkcuer
authors.forename: Ismet
authors.initials: I
authors.lastname: Parlak
mesh_terms: D000328:Adult; D017109:Akathisia, Drug-Induced / Q000517:prevention & control*; D000932:Antiemetics / Q000008:administration & dosage* / Q000009:adverse effects; D054810:Deep Sedation / Q000706:statistics & numerical data*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D009325:Nausea / Q000188:drug therapy*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000932:Antiemetics; D008787:Metoclopramide