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When a person is unwell and is unable to eat (or to eat enough), the lack of nutrition can be a serious obstacle to recovery. In these circumstances, feeding through a feeding tube that enters through the nose and passes through the stomach to the small intestine beyond (a post‐pyloric naso‐enteral feeding tube), is an option.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Bibliographic details: Gong L, Li X, Yang XD, et al.  Meta-analysis of curative effect of Metoclopramide on treating migraine. Journal of Clinical Neurology 2012; 25(2): 92-95

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

This is an updated version of the original Cochrane review published in Issue 11, 2010 (Derry 2010). New searches identified one additional study for inclusion; this study compared paracetamol with etodolac and did not contribute to any of the analyses in the review.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Vomiting caused by acute gastroenteritis is very common in children and adolescents. Treatment of vomiting in children with acute gastroenteritis can be problematic and there is lack of agreement among clinicians on the indications for the use of antiemetics. There have also been concerns expressed about apparently unacceptable levels of side effects with some of the older generation of antiemetics. The small number of included trials provided evidence which appeared to favour the use of antiemetics over placebo to reduce the number of episodes of vomiting due to gastroenteritis in children. A single oral dose of ondansetron given to children with mild to moderate dehydration can control vomiting, avoid hospitalization and intravenous fluid administration which would otherwise be needed. There were no major side effects other than a few reports of increased frequency of diarrhea.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

This is an updated version of the original Cochrane review published in Issue 4, 2010 (Kirthi 2010); no new studies were found. A single oral dose of 1000 mg of aspirin reduced pain from moderate or severe to none by two hours in approximately 1 in 4 people (24%) taking aspirin, compared with about 1 in 10 (11%) taking placebo. Pain was reduced from moderate or severe to no worse than mild pain by two hours in roughly 1 in 2 people (52%) taking aspirin compared with approximately 1 in 3 (32%) taking placebo. Of those who experienced effective headache relief at two hours, more had that relief sustained over 24 hours with aspirin than with placebo. Addition of 10 mg of the antiemetic metoclopramide substantially increased relief of nausea and vomiting compared with aspirin alone, but made little difference to pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

We reviewed the effects of medicines in the treatment of nausea and vomiting in adults in the emergency department.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Thirty‐two studies were included in this review. However, only 22 studies, involving 2658 women, provided data for analysis, looking at interventions given prior to caesarean section for reducing the risk of aspiration. There were several different drugs and drug combinations being considered and the studies were generally of poor or questionable quality. Antacids (like sodium citrate), H2 receptor antagonists (like ranitidine), proton pump antagonists (like omeprazole), all reduced the acidity of the stomach contents. An antacid plus an H2 receptor antagonist also reduced acidity. In theory, a combination like this, where the antacid acts quickly and the H2 receptor antagonists takes a little longer, should protect at periods of greatest risk, i.e. the beginning and end of the procedure (i.e. intubation and extubation). More research is needed to identify the best combination of drugs and to check for possible adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

The objective of the present study was to conduct a systematic review and meta-analysis of randomized controlled trials, comparing metoclopramide with placebo, for preventing vomiting in patients who have received i.v. morphine for acute pain in the emergency setting, and to determine the level of evidence supporting the use of prophylactic metoclopramide in this population. Comprehensive systematic electronic searches were conducted of MEDLINE, EMBASE and the Cochrane Library for randomized controlled trials addressing the clinical question. Reference lists of identified articles were hand-searched. Methodologically appropriate clinical trials identified in the search process were included in a meta-analysis to provide a pooled estimate of effect. Three randomized controlled trials fulfilled the search criteria. All three studies were included in the final meta-analysis that demonstrated an overall result of no difference between metoclopramide and placebo for the primary outcome of vomiting (odds ratios 0.72; 95% confidence intervals 0.11-4.58). There was little evidence that routine prophylactic administration of metoclopramide following the administration of i.v. morphine for acute pain management in the emergency setting is clinically beneficial. Routine metoclopramide administration might expose patients to a risk of harm which is not justifiable given a lack of evidence of benefit.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

As many as three‐quarters of people who receive chemotherapy experience nausea (feeling sick) and vomiting (being sick), which many find distressing. While conventional anti‐sickness medicines are effective, they do not work for everyone, all of the time. Therapeutic drugs based on the active ingredient of cannabis, known as THC (delta‐9‐tetrahydrocannabinol), have been approved for use as anti‐sickness medicines in some countries.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

BACKGROUND/AIMS: The incidence of postoperative nausea and vomiting is truly high after laparoscopic cholecystectomy. Ondansetron and metoclopramide may be effective in preventing it. Our aim was to estimate the efficacy of ondansetron vs. metoclopramide in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Nausea and vomiting occur commonly during and after Caesarean delivery (CD) performed under neuraxial anaesthesia. Metoclopramide is a prokinetic agent reported to be safe in parturients. This meta-analysis assesses the efficacy of metoclopramide for prophylaxis against intra- and postoperative nausea and vomiting (IONV and PONV) in parturients undergoing CD under neuraxial anaesthesia. We performed a literature search of MEDLINE (1966-2011), Cochrane Central Register of Controlled Trials, EMBASE (1947-2011), Google scholar, and CINAHL for randomized controlled trials which compared metoclopramide with placebo in women having CD under neuraxial anaesthesia. Eleven studies with 702 patients were included in the analysis. Administration of metoclopramide (10 mg) resulted in a significant reduction in the incidence of ION and IOV when given before block placement [relative risk (RR) (95% confidence interval, 95% CI)=0.27 (0.16, 0.45) and 0.14 (0.03, 0.56), respectively] or after delivery [RR (95% CI)=0.38 (0.20, 0.75) and 0.34 (0.18, 0.66), respectively]. The incidence of early (0-3 or 0-4 h) PON and POV [RR (95% CI)=0.47 (0.26, 0.87) and 0.45 (0.21, 0.93), respectively] and overall (0-24 or 3-24 h) PON (RR 0.69; 95% CI 0.52, 0.92) were also reduced with metoclopramide. Extra-pyramidal side-effects were not reported in any patient. In conclusion, this review suggests that metoclopramide is effective and safe for IONV and PONV prophylaxis in this patient population. Given the quality of the studies and the infrequent use of neuraxial opioids, these results should be interpreted with caution in current practice and further studies are needed to confirm those findings.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Although severe nausea and vomiting in pregnancy (hyperemesis gravidarum) rarely causes death, it is an important cause of ill health with emotional, physical, and economic consequences. Women may need hospital treatment and may not be able to work and it occasionally causes pregnancy complications and adverse outcomes for babies such as low birthweight. Many pharmaceutical, complementary, and alternative therapies are available and the objective of this review was to examine the effectiveness and safety of interventions for hyperemesis gravidarum.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

This review assessed the efficacy, effectiveness and toxicity of metoclopramide for the treatment of gastroesophageal reflux disease (GERD) in infants. Given the small number of studies found, the lack of similarity between the included studies in terms of population, metoclopramide doses and outcomes, and the small sample sizes and lack of consistency in the literature, the authors' conclusion that there is insufficient evidence to support or oppose the use of metoclopramide for GERD in infants seems appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

The authors concluded that one dose of metoclopramide significantly reduced postoperative nausea and vomiting for patients having surgery under general anaesthesia. Publication bias was possible, the included trials were of variable quality, and the generalisability of the findings was uncertain, making the reliability of the authors' conclusions unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

We performed a systematic review of the effectiveness of anti-emetics for prophylaxis of cisplatin-induced delayed emesis using meta-analysis. We selected 12 reports of randomized controlled trials from MEDLINE (1966-2003. 4) and The Cochrane Library Issue 1, 2003. Nine of these reports were evaluated as high quality and the others as low quality according to the evaluation criteria of Jadad et al., and only the high-quality reports were subjected to meta-analysis. The statistical results obtained from all 12 reports were also compared with those obtained from the 9 reports of high quality. Corticosteroids significantly reduced the occurrence of delayed emesis. Metoclopramide tended to reduce the occurrence of delayed emesis, although not to a significant extent. In contrast, 5-HT3 receptor antagonists did not show a significant prophylactic effect on delayed emesis. Combination treatments using corticosteroids with metoclopramide or 5-HT3 receptor antagonists did not show significant additional benefits over corticosteroids alone. In conclusion, treatment with corticosteroids without additional metoclopramide or 5-HT3 receptor antagonists appears to be preferable for the prevention of delayed emesis induced by cisplatin.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

BACKGROUND: Many recommendations concerning the treatment of nausea and vomiting in palliative care patients exist but what is the evidence for this? Most studies dealing with this topic have focused on cancer patients under chemotherapy and/or radiation therapy or on patients with postoperative nausea. Cancer patients without chemotherapy or radiation therapy, patients without postoperative nausea, and patients having other diseases with palliative care aspects, such as acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), progressive heart failure, amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS) have been underrepresented in studies on nausea and vomiting so far.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Nausea is a common symptom in advanced cancer. While nausea and vomiting can be related to cancer treatments, such as chemotherapy, radiotherapy, or surgery, a significant number of people with advanced cancer also suffer from nausea unrelated to such therapies. Nausea and vomiting may also cause psychological distress, and have a negative impact on the quality of life of cancer patients; it is often under‐treated.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

This review, which assessed the effectiveness of prokinetic agents in patients with functional dyspepsia, concluded that prokinetic agents are effective as a short-term treatment. The review appears to have been conducted appropriately, but the reliability and generalisability of the results is potentially hindered by a number of limitations identified with the included studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

The authors concluded that phenothiazines were more effective than placebo for the treatment of migraine headache and had higher rates of clinical success than other agents. These conclusions are supported by the results of the review and are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Study found evidence that some treatments (ginger, vitamin B6, antihistamines, metoclopramide) were better than placebo for mild symptoms of nausea and vomiting in pregnancy (NVP), but there is little on the effectiveness of treatments in more severe NVP/hyperemesis gravidarum.

Health Technology Assessment - NIHR Journals Library.

Version: October 2016

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