Intravenous prochlorperazine for the rapid control of vomiting in the emergency department

Abstract

In this study, 40 patients whose active vomiting stemmed from various causes were given 2.5 mg of prochlorperazine by slow intravenous push. If no response was observed within 20 minutes, the dosage was repeated. Of 35 patients, 32 responded to doses of 2.5 to 5.0 mg. Three patients experienced no relief of vomiting while in the emergency department, after a total of 5 mg each, in divided doses. These three patients had received morphine sulphate for acute myocardial infarctions. The mean time to cessation of vomiting was 8.5 minutes, versus 35 minutes for a similar group receiving intramuscular prochlorperazine. This difference was statistically significant using analysis of variance (P less than .05). None experienced extrapyramidal reactions, or developed hypotension. We concluded that 2.5 mg of intravenous prochlorperazine given over one minute is an effective, safe treatment for the control of vomiting in the emergency department, until the etiology of the nausea and vomiting is determined and treated specifically. Further double-blind, controlled studies are warranted.