A Cochrane review [Abstract] 1 included 8 studies with a total of 952 subjects. Included were randomized controlled trials (RCTs) of any drug in the treatment of nausea and vomiting in the treatment of adults in the emergency department (ED). In five trials differences in mean VAS change from baseline to 30 minutes between placebo were measured and the drugs evaluated were: metoclopramide, ondansetron, prochlorperazine, promethazine and droperidol. The only statistically significant change in baseline VAS to 30 minutes was for droperidol, in a single trial of 48 participants. Other included trials evaluated a drug compared to "active controls" (alternative antiemetic). There was no convincing evidence of superiority of any particular drug compared to active control.
Participants receiving placebo often reported clinically significant improvement in nausea, implying general supportive treatment such as intravenous fluids may be sufficient for the majority of people. If a drug is considered necessary, choice of drug may be dictated by other considerations such as a person's preference, adverse effect profile and cost.
Abstract and full text in Cochrane database http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010106.pub2/information (licence for full text required)
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