Metoclopramide does not influence the frequency of propofol-induced spontaneous movements

Study Objective: To evaluate the effects of metoclopramide on the frequency and severity of propofol-induced movements. Design: Randomized, double blind, placebo-controlled trial. Setting: Veterans Administration Medical Center. Patients: One hundred thirty-seven consenting adults scheduled to receive general anesthesia with propofol induction. Interventions: Patients were randomized to receive either metoclopramide 10 mg intravenously (IV) or placebo (saline) 3 min before induction of general anesthesia. All patients received midazolam 1 to 2 mg IV, fentanyl 50 to 150 μg IV, and lidocaine 50 to 80 mg IV before induction of anesthesia. Measurements: Occurrence of spontaneous movements and severity during the observation period were recorded after propofol induction by observing movement in the hands/arms and feet/legs, as well as presence of a hiccup. The dosage of anesthetic medications administered was also recorded for each patient. Main Results: No differences were noted in the frequency and severity of spontaneous movement in the patients who had received metoclopramide and placebo. However, compared with the patients who did not move, patients who experienced movements received a significantly higher dose of propofol (P = 0.025) and a lower dose of fentanyl (P = 0.049). Conclusions: Metoclopramide does not affect the frequency of propofol-induced movements, but propofol and fentanyl doses influence the frequency of movements during propofol induction.