Administration of metoclopramide by infusion or bolus does not affect the incidence of drug-induced akathisia
MetadataShow full item record
Objective: The study aims to determine if slow intravenous infusion of metoclopramide reduces the incidence of acute drug-induced akathisia (DIA) compared with intravenous bolus. Methods: A prospective, double-blind, double dummy trial of adult patients requiring intravenous metoclopramide in the ED. Participants were randomised to receive either: metoclopramide 20mg as a bolus and normal saline infusion over 15min, or normal saline bolus and metoclopramide 20mg infused over 15min. Patients were assessed for DIA using the Prince Henry Akathisia Rating Scale before treatment was commenced and at 20, 40 and 60min post. Nausea was assessed with a visual analog scale. Results: Of 210 participants assessed for eligibility, 206 were randomised and 205 were included in the final analysis. Participant characteristics and indication for metoclopramide were well matched between the treatment groups. Overall, incidence of DIA was 26 out of 205 participants (12.68%, 95% confidence interval [CI] 8.09-17.3). DIA occurred in 11 out of 103 (10.68%, 95% CI 4.61-16.74%) in the bolus group, and in 15 out of 102 (14.71%, 95% CI 7.71-21.70%) in the infusion group (P = 0.67). Severe DIA occurred in six patients in each group. The mean age of patients experiencing DIA was 34 years (interquartile range 29-40) and 42 years (interquartile range 40-45) in those without akathisia (P = 0.04). Nausea reduction was equivalent in both groups. Conclusion: The incidence of DIA and reduction in nausea is unaffected by the rate of administration of intravenous metoclopramide 20mg.
Showing items related by title, author, creator and subject.
REstricted Fluid REsuscitation in Sepsis-associated Hypotension (REFRESH): Study protocol for a pilot randomised controlled trialMacdonald, S.; Taylor, D.; Keijzers, G.; Arendts, G.; Fatovich, D.; Kinnear, F.; Brown, S.; Bellomo, R.; Burrows, S.; Fraser, J.; Litton, E.; Ascencio-Lane, J.; Anstey, Matthew; McCutcheon, D.; Smart, L.; Vlad, I.; Winearls, J.; Wibrow, B. (2017)Background: Guidelines recommend an initial intravenous (IV) fluid bolus of 30 ml/kg isotonic crystalloid for patients with sepsis and hypotension. However, there is a lack of evidence from clinical trials to support this. ...
Intravenous iron or placebo for anaemia in intensive care: the IRONMAN multicentre randomized blinded trial: A randomized trial of IV iron in critical illnessThe, I.; Litton, E.; Baker, S.; Erber, W.; Farmer, Shannon; Ferrier, J.; French, C.; Gummer, J.; Hawkins, D.; Higgins, A.; Hofmann, A.; De Keulenaer, B.; McMorrow, J.; Olynyk, John; Richards, T.; Towler, S.; Trengove, R.; Webb, S.; The, A. (2016)© 2016, Springer-Verlag Berlin Heidelberg and ESICM.Purpose: Both anaemia and allogenic red blood cell transfusion are common and potentially harmful in patients admitted to the intensive care unit. Whilst intravenous ...
The prevalence of peripheral intravenous cannulae and pattern of use: A point prevalence in a private hospital settingWong, K.; Cooper, A.; Brown, Janie; Boyd, L.; Levinson, M. (2018)AIMS AND OBJECTIVES: To determine the prevalence and pattern of use of peripheral intravenous cannulae in hospital wards. BACKGROUND: Peripheral intravenous cannulae are commonly used in acute health care to directly ...