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Gender differences in narcotic-induced emesis in the ED
Leslie S Zun1, La Vonne A Downey, William Gossman
1Department of Emergency Medicine, Finch University/Chicago Medical School and Mount Sinai Hospital Medical Center, Chicago, IL 60608, USA. zuni@sinai.org
The American Journal of Emergency Medicine
|May 7, 2002
Summary
Nausea and vomiting are common side effects of narcotic pain relief in the emergency department. This study found that female patients and certain pain causes were significantly associated with these narcotic-induced side effects.
Area of Science:
- Emergency Medicine
- Clinical Pharmacology
- Toxicology
Background:
- Narcotic analgesics are frequently administered in emergency departments for pain management.
- Narcotic-induced nausea and vomiting (NINV) is a recognized complication, but its incidence and associations, particularly concerning gender, are not well-defined.
Purpose of the Study:
- To investigate the incidence of nausea and vomiting following opiate administration for pain relief in the emergency department (ED).
- To determine if there are sex-related differences in the occurrence of NINV.
- To identify factors associated with NINV, including cause of injury and drug administration route.
Main Methods:
- A prospective convenience study was conducted in an innercity Level I Trauma Center.
- Data on patient demographics, reason for narcotics, complications, drug details, and administration route were collected.
- Statistical analysis, including independent t-tests and Bonferroni correction, was used to compare outcomes between men and women.
Main Results:
- Of 325 patients, 20.3% required anti-emetics for nausea and/or vomiting.
- Nausea and vomiting were significantly associated with female sex and specific causes of pain.
- Women were more likely to receive intramuscular (IM) administration, while men predominantly received intravenous (IV) administration, with differences noted in anti-emetic requirements.
Conclusions:
- A significant number of patients experience nausea and/or vomiting from ED-administered narcotics.
- Female sex and the nature of the pain are significant factors associated with NINV.
- Further comparative studies on different pain medications for NINV incidence are warranted.