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Metoclopramide for migration of naso-enteral tubeSilva Cda, Saconato H, Atallah ÁN SummaryMetoclopramide for migration of naso-enteral feeding tubeMetoclopramide enhanced the migration of naso-enteral tubes, but the results were not statistically significant. The reasons may include: small studies, underpowered, and varying doses. In clinical practice, clinicians should no longer use metoclopramide for this purpose, however, more randomised clinical trials should be performed with a significant sample administering metoclopramide or not.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 2, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
October 21. 2002 AbstractBackgroundEnteral alimentation by feeding tube is a common problem and an 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. ObjectivesTo determine the effect of intravenous metoclopramide on transpyloric passage of the naso-enteral tube. Search strategyRelevant RCTs were identified by electronic search through MEDLINE, EMBASE, LILACS and the Cochrane Controlled Trials Register databases in 2002. The searches were rerun in November 2003, November 2004 and October 2005 - no relevant trials were found. Selection criteriaTypes of participants: Adults needing enteral nutrition. Data collection and analysisThe reviewers evaluated the allocation concealment, which was classified as adequate, uncertain or inadequate. Two reviewers extracted the data independently. All analyses were performed according to the intention-to-treat method. Main resultsFour studies were included and analysed. There was no statistically significant difference between intravenous or intramuscular metoclopramide administered to promote the 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 10.84) were equally ineffective in facilitating transpyloric intubation. Authors' conclusionsFour studies were included and analysed. There was no statistically significant difference between intravenous or intramuscular metoclopramide administered to promote the 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 10.84) were equally ineffective in facilitating transpyloric intubation. |