Antiemetics Might Not Provide Rapid Relief for Patients with Undifferentiated Nausea and Vomiting

Emergency department (ED) patients with nausea and vomiting are often treated with antiemetics. To evaluate the efficacy of two commonly used intravenous antiemetic drugs, investigators conducted a randomized, double-blind, placebo-controlled trial involving 258 adults (median age, 42) with nausea and vomiting at two Australian EDs. Symptoms were due to opioids (29%), gastroenteritis (22%), other infections (8%), renal colic (6%), pain (5%), and other causes. Patients received saline (250 mL/hour) plus ondansetron (4 mg), metoclopramide (20 mg), or placebo.

No significant differences in nausea were observed among the three groups 30 minutes after study drug administration. At enrollment, median self-rated nausea severity on a standard 100-mm…