| Abstract: | Objective : To determine if there is benefit in routine administration of the anti-emetic metoclopramide to patients receiving intravenous morphine for musculoskeletal trauma. Method : A randomized double-blind placebo controlled trial using 214 patients who presented to Dunedin Hospital Emergency Department with musculoskeletal trauma, requiring intravenous morphine for analgesia. Those recruited were randomized to two groups. Group one received placebo prior to morphine while those in group two received metoclopramide 10 mg intravenously, prior to morphine. Any vomiting or severe nausea within 2 h of receiving intravenous morphine was recorded. Results : The two groups were evenly matched for age, sex and morphine dose. Overall, 3.7% of patients in the study vomited (1.9% in the group receiving placebo and 5.4% in the group receiving metoclopramide). This difference was not significant (P = 0.17). The mean age was 78.5 years in the group that did vomit compared with a mean age of 46.0 years in those not vomiting. This difference was highly significant (P = 0.0009). Conclusion : The incidence of vomiting in patients receiving intravenous morphine for musculoskeletal trauma is low and the routine use of an anti-emetic in these patients is not justified. Intravenous metoclopramide in these patients does not reduce the incidence of vomiting. |
