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Pain & sedation

No benefit from prophylaxis for opioid nausea

Prophylaxis of opioid-induced nausea in helicopter emergency medical service: a prospective quasi-experimental study
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · Added 7 May 2026

Prospective study of 205 HEMS patients comparing ondansetron prophylaxis, aromatherapy, and no prophylaxis for opioid-induced nausea — neither intervention showed benefit compared to no prophylaxis in unselected patients.

Study type

Cohort

Design

Prospective quasi-experimental rotating-schedule study across six HEMS bases

Participants

205 patients >16 given opioids for traumatic pain (86 no prophylaxis, 64 ondansetron, 55 aromatherapy)

Main finding

Median NRS change 0 in all groups; NRS increase in 15%, 14%, 15%; NRS>3 in 14% vs 11% vs 11%; vomiting 4%, 2%, 0%. Neither ondansetron nor aromatherapy showed benefit over no prophylaxis.

Caveat

Quasi-experimental rotating allocation, single HEMS system, modest sample size

Bottom line

Hypothesis-generating

Learning goal

Weigh whether routine antiemetic prophylaxis is warranted when giving opioids for traumatic pain in the prehospital setting.

More

• Topic: Pain & sedation
• Daily scan: 7 May 2026

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