Inhalation of isopropyl alcohol is known to relieve postoperative nausea and vomiting, but little is known about its therapeutic efficacy in patients presenting to the ED. In a new study, aromatherapy with inhaled isopropyl alcohol was compared with oral ondansetron for the management of nausea in ED patients.

A convenience sample of 122 adults presenting to the ED with a chief complaint of nausea or vomiting were randomly assigned to one of three study arms: (1) inhaled isopropyl alcohol plus 4-mg oral ondansetron; (2) inhaled isopropyl alcohol plus oral placebo; and (3) inhaled saline solution placebo plus 4-mg oral ondansetron. Subjects could receive usual care and rescue antiemetic therapy as needed. The primary outcome was mean change in nausea from baseline to 30 minutes postintervention as measured by two visual analog scales, with 0 mm indicating no nausea or pain and 100 mm signifying the worst nausea or pain imaginable.

Mean reduction in nausea at 30 minutes was 30 mm in patients receiving isopropyl alcohol plus ondansetron, 32 mm in those receiving isopropyl alcohol plus placebo, and 9 mm in those receiving the inhaled saline solution plus ondansetron. Both groups receiving isopropyl alcohol, either alone or in combination with ondansetron, generally had lower mean nausea scores throughout their ED stay than the group that received the inhaled saline solution plus ondansetron.

The authors conclude that it may be reasonable to prescribe aromatherapy with repeated inhalations of isopropyl alcohol at 10-minute intervals as needed for nausea relief in outpatients, although a traditional antiemetic may also be needed for long-term relief.

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