Comparing the Effect of Slow and Fast Infusion of Metochelopramid on Akathisia in Patients with Cancer

Background and purpose: Metoclopramide is frequently used in emergency departments to control nausea, vomiting, and headache. This study aimed at comparing the effects of two rates of intravenous infusion of metoclopramide (slow and fast bolus) on the incidence of akathisia in patients with cancer in an emergency department. In a double blind clinical trial, 112 patients with cancer hospitalized in Sari Imam Khomaini emergency department were included. The participants were randomized to receive either 20 mg metoclopramide as a bolus and normal saline infusion over 20 min (bolus group), or normal saline bolus and 20 mg metoclopramide infused over 20 min (infusion group). Patients were assessed for akathisia using the Prince Henry Akathisia Rating Scale. Nausea, sedation, pulse, and blood pressure were measured in both groups at 0, 30, 60, and 120 min after drug administration. The mean ages of patients in bolus and infusion group was 59.4 ± 16.1 and 60.3 ± 14.2, respectively. Frequency of women in bolus and infusion group was 48.3 and 56.1%, respectively. Objective akathisia in patients receiving bolus metoclopramide was 4 times more than that in infusion group. (P=0.000) (RR: 4, CI: 95%: 1.8-6.5). Trend of sleepiness was not significantly different between the two groups (P=0.625). But, the trends of nasaue, pulse, and hypertension showed significant differences between blouse and infusion groups. (P=0.000 and P=0.000, respectively). Current findings showed that intravenous infusion of metoclopramide could reduce objective akathisia and nausea.