METOCLOPRAMIDE IN TRAUMA CT SCANNING - PREVENTING EMESIS OF ORAL RADIOGRAPHIC CONTRAST

Vomiting of gastric contents is common among multisystem trauma patien ts and may cause significant morbidity. A study was conducted to exami ne whether metoclopramide (Reglan), an antiemetic and promotility agen t, could decrease vomiting after administration of oral radiographic c ontrast in stable multisystem trauma patients undergoing computed tomo graphy (CT) of the abdomen (''trauma CT patients''). The charts of 193 patients listed in the Duke Trauma Registry who underwent abdominal C T scanning from January, 1992 until February, 1993 were reviewed. The emergency department record was reviewed for documentation of vomiting , use of intravenous metoclopramide, and other potential confounders o f vomiting such as age, pharmacologic paralysis, and head injury as me asured by the Glasgow Coma Scale (GCS). Patients who received intraven ous metoclopramide were six times less likely to vomit after administr ation of oral radiographic contrast than those who did not receive the drug. This effect increased to a twelvefold protective effect after c orrecting for age, pharmacologic paralysis, and GCS. These preliminary findings strongly suggest that routine use of metoclopramide may prev ent vomiting of gastric contents after administration of oral radiogra phic contrast in trauma CT patients. A future prospective study is rec ommended to confirm these results. Copyright (C) 1996 by W.B. Saunders Company.