Intervention Review

Metoclopramide for migration of naso-enteral tube

  1. Cristiane da Silva1,*,
  2. Humberto Saconato2,
  3. Álvaro N Atallah3

Editorial Group: Cochrane Upper Gastrointestinal and Pancreatic Diseases Group

Published Online: 8 JUL 2009

Assessed as up-to-date: 23 DEC 2008

DOI: 10.1002/14651858.CD003353

Database Title

Additional Information

How to Cite

Silva CD, Saconato H, Atallah ÁN. Metoclopramide for migration of naso-enteral tube. Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.: CD003353. DOI: 10.1002/14651858.CD003353.

Author Information

  1. 1

    Faculdade Santa Marcelina, Enfermagem, São Paulo, São Paulo, Brazil

  2. 2

    Federal University of Rio Grande do norte, Department of Medicine, São Paulo, Vila Clementino, Brazil

  3. 3

    Universidade Federal de São Paulo / Escola Paulista de Medicina, Brazilian Cochrane Centre, São Paulo, SP, Brazil

*Cristiane da Silva, Enfermagem, Faculdade Santa Marcelina, Rua Cabo Joao Teruel Fregoni 307 cs 11 qd 04 Ponte Grande /Guarulhos, São Paulo, São Paulo, 07032-000, Brazil. gtadeuccreis@uol.com.br. cristiane.reis@fasm.edu.br.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 8 JUL 2009

SEARCH

ARTICLE TOOLS

View Full Article (HTML) Summary (57K)Standard (175K)Full (199K)
 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Enteral alimentation by feeding tube is a common and efficient method of providing nutritional support to hospitalized patients with insufficient oral intake, but adequate gastrointestinal function. The use of metoclopramide, a prokinetic agent, has been recommended to achieve transpyloric placement, but its efficacy is controversial.

Objectives

To determine the effect of intravenous metoclopramide on transpyloric passage of the naso-enteral tube.

Search methods

Trials were identified by searching MEDLINE 1996 to November 2008, EMBASE 1988 to November 2008, LILACS 2005 to November 2008, the Cochrane Controlled Trials Register, and The Cochrane Library (Issue 4, Year 2008)  We did not confine our search to English language publications. Searches in all databases were updated in January 2005 update and November 2008. No new studies were found in 2008.

Selection criteria

Types of participants: Adults needing enteral nutrition.
Types of intervention: Intravenous or intramuscular metoclopramide compared to placebo or no intervention.
Types of studies: Randomised controlled trials.
Types of outcome measures: The success of migration of transpyloric intubation.

Data collection and analysis

The reviewers evaluated the allocation concealment, which was classified as adequate, uncertain or inadequate. Two reviewers extracted data independently. All analyses were performed according to the intention-to-treat method.

Main results

Four studies were included and analysed. There was no statistically significant difference between intravenous or intramuscular metoclopramide administered to promote tube migration (OR 0.65, 95% CI 0.33 to 1.28). Intravenous metoclopramide 10 mg (OR 0.68, 95% CI 0.37 to 1.23) and 20 mg (OR 0.27, 95% CI 0.01 to 10.83) were equally ineffective in facilitating transpyloric intubation.

Authors' conclusions

Metoclopramide enhanced the migration of naso-enteral tubes, but the results did not reach conventional statistical significance. The reasons may include: small studies, underpowered, varying doses, etc. In clinical practice, clinicians should no longer use metoclopramide for this purpose. However, more randomised clinical trials should be performed with a significant sample size, administering metoclopramide or not. The use of metoclopramide may include adverse reactions, such as depression, high blood pressure, decrease of libido, headache, skin rash, fatigue, fever, hyperactivity, insomnia, nausea, sedation, drowsiness, agitation, extrapyramidal reactions (impaired speech or impaired swallowing, unsteady gait, inflexibility of upper and lower members, tremor).

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Metoclopramide for migration of naso-enteral feeding tube

Metoclopramide enhanced the migration of naso-enteral tubes, but the results were not statistically significant. In clinical practice, clinicians should no longer use metoclopramide for this purpose, however, more randomised clinical trials should be performed with metoclopramide. People who are given metoclopramide may experience adverse reactions.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

Metoclopramide促進鼻腸內管移位

以餵食管來提供腸道營養是一種常見的問題和有效的方法, 它提供口服攝入不足但胃腸道功能正常的住院病人營養支持。metoclopramide是一種蠕動促進劑，被建議來達成鼻腸管通過幽門的置放, 但其效果是有爭議的。

目標

為了確定靜脈注射metoclopramide對鼻腸管通過幽門的置放效果。

搜尋策略

相關的隨機對照研究，經由電子搜尋2002年的MEDLINE, EMBASE, LILACS和Cochrane Controlled Trials Register databases。重新搜查了2003年11月，2004年11月和2005年10月沒有相關的試驗被發現。

選擇標準

參與者的類型：成人需要腸道營養; 治療的類型：靜脈或肌肉注射metoclopramide與安慰劑相比，或沒有治療; 研究的類型：隨機對照試驗; 結果測量的類型：鼻腸管成功的通過幽門置放。

資料收集與分析

審稿人評估分配的隱瞞，分類為適當，不確定或不適當。兩個評審獨立提取數據。所有的分析進行了根據意向治療的方法。

主要結論

四份研究報告列入回顧和分析。靜脈或肌肉注射metoclopramide是否能促進鼻腸內管移位沒有統計學差異(勝算率為0.65 ， 95 ％CI為0.33至1.28)。靜脈注射metoclopramide10毫克(勝算率為0.68 ， 95 ％CI為0.37至1.23)和20 mg (勝算率為0.27 ， 95 ％CI為0.01 ～10.84)對促進鼻腸內管移位也同樣無效。

作者結論

四份研究報告列入回顧和分析。靜脈或肌肉注射metoclopramide是否能促進鼻腸內管移位沒有統計學差異(勝算率為0.65 ， 95 ％CI為0.33至1.28)。靜脈注射metoclopramide10毫克(勝算率為0.68 ， 95 ％CI為0.37至1.23)和20 mg (勝算率為0.27 ， 95 ％CI為0.01 ～10.84)對促進鼻腸內管移位也同樣無效。

翻譯人

本摘要由臺中榮民總醫院周佳滿翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

空白

View Full Article (HTML) Summary (57K)Standard (175K)Full (199K)