Participants and data collection
nausea or vomiting symptoms, renal colic, gallbladder colic, pain, musculoskeletal pain, headache, NRS
DISEASE
We include patients who presented to the ED during the study period who fulfilled the following criteria: (1) aged more than or equal to 18 years, and (2) presented with any type of acute painful conditions, including headache, musculoskeletal pain, renal colic, gallbladder colic, with moderate to severe intensity (pain scale ≥ 5 in Numerical Rating Scale (NRS)). Patients with one of the following conditions were excluded from the study: pregnancy or lactation, contraindicated to tramadol or metoclopramide, had nausea or vomiting symptoms upon study inclusion, or at the time of randomization, patient who were at high risk for extrapyramidal side effects, patients who were treated with drugs other than intravenous Tramadol, patients who could not provide informed consent, and patients with previous antiemetic use.We collected baseline data on age, sex, underlying disease, location of pain, and severity of pain recorded in NRS.