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Rate of metoclopramide infusion affects the severity and incidence of akathisia.
Emerg Med J. 2005 Sep; 22(9):621-4.EM

Abstract

OBJECTIVE

To investigate the effect of the rate of metoclopramide infusion on akathisia incidence, severity, onset of symptoms, and duration in patients with headache, and/or nausea/vomiting in the emergency department (ED) setting.

METHODS

Prospective, double blind, randomised clinical study comparing two rates of intravenous infusion of metoclopramide over a period of six months at a tertiary university hospital ED.

RESULTS

A total of 300 patients presented to the ED met the inclusion criteria: 151 (50.3%) with nausea/vomiting, 108 (36%) with headache, and 41 (13.7%) with headache and nausea/vomiting. Of these, 154 patients (51.3%) were given 10 mg metoclopramide as a slow intravenous infusion over 15 minutes plus placebo (SIG group) and 146 patients were given 10 mg metoclopramide intravenous bolus infusion over two minutes plus placebo (BIG group). Nine of the 154 patients in the SIG group (5.8%) had akathisia compared with 36/146 patients (24.7%) in the BIG group (p < 0.001, OR 5.273, 95% CI 2.43 to 11.403). Severe akathisia were observed in 13/45 (28.8%). The incidence of severe akathisia was significantly higher in the BIG group (30.5%; 11/36) than in the SIG group (22.2%; 2/9), p = 0.009. Metoclopramide successfully relieved the presenting symptom(s) of 137/146 (90.8%) and 139/154 (90.2%) patients in the BIG and SIG groups, respectively.

CONCLUSIONS

This study suggests that slowing the rate of infusion of metoclopramide is an effective strategy for reducing the incidence of akathisia in patients with headache, and/or nausea/vomiting in ED.

Authors+Show Affiliations

Department of Emergency Medicine, Dokuz Eylul University Hospital, Inciralti 35340, Izmir, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16113179

Citation

Parlak, I, et al. "Rate of Metoclopramide Infusion Affects the Severity and Incidence of Akathisia." Emergency Medicine Journal : EMJ, vol. 22, no. 9, 2005, pp. 621-4.
Parlak I, Atilla R, Cicek M, et al. Rate of metoclopramide infusion affects the severity and incidence of akathisia. Emerg Med J. 2005;22(9):621-4.
Parlak, I., Atilla, R., Cicek, M., Parlak, M., Erdur, B., Guryay, M., Sever, M., & Karaduman, S. (2005). Rate of metoclopramide infusion affects the severity and incidence of akathisia. Emergency Medicine Journal : EMJ, 22(9), 621-4.
Parlak I, et al. Rate of Metoclopramide Infusion Affects the Severity and Incidence of Akathisia. Emerg Med J. 2005;22(9):621-4. PubMed PMID: 16113179.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rate of metoclopramide infusion affects the severity and incidence of akathisia. AU - Parlak,I, AU - Atilla,R, AU - Cicek,M, AU - Parlak,M, AU - Erdur,B, AU - Guryay,M, AU - Sever,M, AU - Karaduman,S, PY - 2005/8/23/pubmed PY - 2005/9/16/medline PY - 2005/8/23/entrez SP - 621 EP - 4 JF - Emergency medicine journal : EMJ JO - Emerg Med J VL - 22 IS - 9 N2 - OBJECTIVE: To investigate the effect of the rate of metoclopramide infusion on akathisia incidence, severity, onset of symptoms, and duration in patients with headache, and/or nausea/vomiting in the emergency department (ED) setting. METHODS: Prospective, double blind, randomised clinical study comparing two rates of intravenous infusion of metoclopramide over a period of six months at a tertiary university hospital ED. RESULTS: A total of 300 patients presented to the ED met the inclusion criteria: 151 (50.3%) with nausea/vomiting, 108 (36%) with headache, and 41 (13.7%) with headache and nausea/vomiting. Of these, 154 patients (51.3%) were given 10 mg metoclopramide as a slow intravenous infusion over 15 minutes plus placebo (SIG group) and 146 patients were given 10 mg metoclopramide intravenous bolus infusion over two minutes plus placebo (BIG group). Nine of the 154 patients in the SIG group (5.8%) had akathisia compared with 36/146 patients (24.7%) in the BIG group (p < 0.001, OR 5.273, 95% CI 2.43 to 11.403). Severe akathisia were observed in 13/45 (28.8%). The incidence of severe akathisia was significantly higher in the BIG group (30.5%; 11/36) than in the SIG group (22.2%; 2/9), p = 0.009. Metoclopramide successfully relieved the presenting symptom(s) of 137/146 (90.8%) and 139/154 (90.2%) patients in the BIG and SIG groups, respectively. CONCLUSIONS: This study suggests that slowing the rate of infusion of metoclopramide is an effective strategy for reducing the incidence of akathisia in patients with headache, and/or nausea/vomiting in ED. SN - 1472-0213 UR - https://www.unboundmedicine.com/medline/citation/16113179/Rate_of_metoclopramide_infusion_affects_the_severity_and_incidence_of_akathisia_ L2 - http://emj.bmj.com/cgi/pmidlookup?view=long&amp;pmid=16113179 DB - PRIME DP - Unbound Medicine ER -