Unfortunately the Australasian journal (Emergency Medicine) is not on
medline although a decision is pending!
The role of prophylactic anti-emetic therapy in emergency department
patients receiving intravenous morphine for musculoskeletal trauma
Emergency Medicine(1999) 11, 240-243
Lambie, Chambers and Herbison
Dunedin Hospital, Dunedin NZ
A randomised double blind controlled trial 214 patients comparing
metoclopramide with placebo
3.7% vomited (1.9% in the control group and 5.4% in the group receiving
metoclopramide)
Hardly any vomiters in this selected group
mean age of vomiters 78.5
mean age of non vomiters 46.0 This was highly significant p=0.0009
Few vomited and they were almost all old!
We resticted to musculoskeletal trauma in an attempt to remove other
clinical causes of vomiting apart from the opioid
took 8 months to do this small study
it should be possible to set up multicente comtrol trials to answer
these simple questions in one weekend with thousands of patients!
I use ondansetron as a prophylactic antiemetic when it really matters
JohnC
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