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Motion Sickness: Comparison of Metoclopramide and Diphenhydramine to Placebo

Published online by Cambridge University Press:  11 October 2011

Stephanie Rubio ,
Lori Weichenthal  and
Jim Andrews
Stephanie Rubio
Affiliation:
Kaiser Permanente Medical Center, Fresno, California USA
Lori Weichenthal*
Affiliation:
Department of Emergency Medicine, UCSF-Fresno Medical Education Program, Community Regional Medical Center, Fresno California USA
Jim Andrews
Affiliation:
Department of Emergency Medicine, UCSF-Fresno Medical Education Program, Community Regional Medical Center, Fresno California USA
*
Correspondence: Lori Weichenthal, MD 155 North Fresno Street, Suite 206Fresno, California 93701-2302 USA E-mail: lweichenthal@fresno.ucsf.edu
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Abstract

Objectives: This is an evaluation of the efficacy of metoclopramide (MTCP) or diphenhydramine (DPH) to relieve symptoms of motion sickness in patients being transported via ambulance in a mountainous setting.

Methods: This is a prospective, randomized, double-blinded, placebo-controlled study of patients transported by ambulance in the Sierra Nevada mountains of Fresno County. Consenting patients who met the inclusion criteria were asked to rate their motion sickness every five minutes using a visual analog scale (VAS) during transport. If motion sickness occurred, they were randomized to receive MTCP (20 mg IV), DPH (50 mg IV), or placebo (normal saline), and remaining symptoms were recorded every five minutes. If signs and symptoms of motion sickness persisted after 15 minutes, a rescue dose of MTCP was offered.

Results: Twenty-six patients were enrolled in the study. Twenty-two (84.6%) developed motion sickness and were randomized to MTCP, DPH, or placebo. Eight patients received MTCP, seven received DPH, and seven received placebo. The MTCP group showed a statistically significant decrease in the mean VAS score at 15 minutes compared to the DPH and placebo groups. There was no significant difference in the decrease in VAS score between the placebo and the DPH group. Twelve out of 22 patients requested a rescue dose of MTCP after 15 minutes. At 25 minutes, there was no significant difference in the VAS score between the three groups.

Conclusion: During ambulance transport in a mountainous setting, the administration of MTCP is superior to both DPH and placebo in the treatment of motion sickness. Diphenhydramine is not superior to placebo.

Keywords

BenadrylMetoclopramidemotion sicknessprehospital
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 26 , Issue 4 , August 2011 , pp. 305 - 309
Copyright
Copyright Rubio © World Association for Disaster and Emergency Medicine 2011

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