Prophylactic Intravenous Metoclopramide Use in Patients Given Intravenous Tramadol: A Retrospective Cross-Sectional Study [TRAMAX STUDY]

Abstract: The routine use of Intravenous prophylactic antiemetics with Intravenous opioid analgesics is common practice in the Emergency & Trauma Department (ETD) of Hospital Tuanku Ampuan Najihah (HTAN) to prevent opioid-induced nausea and vomiting. However, this practice has dubious clinical benefits, generates additional costs, and might expose patients to potentially adverse effects. Approximately 6000 ampules of IV Metoclopramide are used by ETD HTAN annually. The sum seems ignorable, but in 10 years, this may total over RM1,000,000. The study aimed to evaluate the benefit of intravenous metoclopramide prophylaxis in patients receiving intravenous tramadol for acute pain relief. A retrospective cross-sectional study was conducted at the ETD of HTAN using convenient sampling. Patient details were extracted from the medical record via standardized data collection form and analysed with the Statistical Package for Social Sciences version 25. A total of 272 patients were included, half of whom were given intravenous Metoclopramide prophylactically. The overall incidence of nausea in the study population was 12.1%, with most cases rated mild. Only two patients (0.7%) in the metoclopramide group vomited within 2 hours of intravenous tramadol administration, which did not demonstrate a statistically significant association between metoclopramide prophylaxis and reduced emesis episode (P= 0.498, Fisher's exact test). The low incidence of nausea and vomiting does not warrant the prophylactic use of intravenous Metoclopramide in tramadol-treated patients, suggesting a need to educate ETD medical officers on the findings to implement change in the routine prescribing practice in HTAN and subsequent cluster hospitals. Keywords: metoclopramide, tramadol, nausea, vomiting, emesis, prophylaxis. Title: Prophylactic Intravenous Metoclopramide Use in Patients Given Intravenous Tramadol: A Retrospective Cross-Sectional Study [TRAMAX STUDY] Author: Keerthy Venthen Krishna Kumar, Yu Xin Tan, Pavithrah Asogan International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 13, Issue 1, April 2025 - September 2025 Page No: 44-48 Research Publish Journals Website: www.researchpublish.com Published Date: 23-April-2025 DOI: https://doi.org/10.5281/zenodo.15267834 Paper Download Link (Source) https://www.researchpublish.com/papers/prophylactic-intravenous-metoclopramide-use-in-patients-given-intravenous-tramadol-a-retrospective-cross-sectional-study-tramax-study