Tramadol is widely used as analgesic in trauma patients. However, it causes side effects, most notably nausea and vomiting. This study aim to determine the role of prophylactic metoclopramide in preventing tramadol induced nausea and vomiting.

Inclusion Criteria:

• Patients aged 18 years or older on day of presentation to ETD SGH
• Sustained from traumatic injuries of extremities (Fracture of hand & wrist, radius, ulna, humerus, femur, tibia, fibula and/or foot & ankle; laceration wounds of extremities; soft tissue injury)
• Patient who is able to give consent

Exclusion Criteria:

• Known allergy to metoclopramide
• Concurrently taking medication with anti-emetic effect, including antihistamines, phenothiazines and dopamine antagonists.
• A history of vomiting since time of injury
• Patients who had already received tramadol or metoclopramide in the previous 8 hours prior to arrival at ETD
• Below age of 18 on day of presentation, or patients who could not consent to the study
• Any alteration in level of consciousness
• Hemodynamic instability or primary diagnosis requiring time critical intervention
• Pregnancy or lactation
• History or known case of vertiginous disorder
• Currently undergoing chemotherapy or radiotherapy

The study drugs were prepared under sterile conditions by a pharmacist independent to the study and kept in packs.The patients recruited were randomized to receive one of the study packs. The study pack were numbered by the pharmacist, who used a computer-generated random number sequence to assign treatment allocations. The allocation list was kept by the pharmacist. Treatment allocations were revealed only after study completion, when all outcome measurements had been performed and recorded by the investigator in the study database.