Drugs for preventing postoperative nausea and vomiting
- PMID: 16856030
- PMCID: PMC6463839
- DOI: 10.1002/14651858.CD004125.pub2
Drugs for preventing postoperative nausea and vomiting
Update in
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WITHDRAWN: Drugs for preventing postoperative nausea and vomiting.Cochrane Database Syst Rev. 2017 Jul 17;7(7):CD004125. doi: 10.1002/14651858.CD004125.pub3. Cochrane Database Syst Rev. 2017. PMID: 28715610 Free PMC article.
Abstract
Background: Drugs can prevent postoperative nausea and vomiting, but their relative efficacies and side effects have not been compared within one systematic review.
Objectives: The objective of this review was to assess the prevention of postoperative nausea and vomiting by drugs and the development of any side effects.
Search strategy: We searched The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 2, 2004), MEDLINE (January 1966 to May 2004), EMBASE (January 1985 to May 2004), CINAHL (1982 to May 2004), AMED (1985 to May 2004), SIGLE (to May 2004), ISI WOS (to May 2004), LILAC (to May 2004) and INGENTA bibliographies.
Selection criteria: We included randomized controlled trials that compared a drug with placebo or another drug, or compared doses or timing of administration, that reported postoperative nausea or vomiting as an outcome.
Data collection and analysis: Two authors independently assessed trial quality and extracted outcome data.
Main results: We included 737 studies involving 103,237 people. Compared to placebo, eight drugs prevented postoperative nausea and vomiting: droperidol, metoclopramide, ondansetron, tropisetron, dolasetron, dexamethasone, cyclizine and granisetron. Publication bias makes evidence for differences among these drugs unreliable. The relative risks (RR) versus placebo varied between 0.60 and 0.80, depending upon the drug and outcome. Evidence for side effects was sparse: droperidol was sedative (RR 1.32) and headache was more common after ondansetron (RR 1.16).
Authors' conclusions: Either nausea or vomiting is reported to affect, at most, 80 out of 100 people after surgery. If all 100 of these people are given one of the listed drugs, about 28 would benefit and 72 would not. Nausea and vomiting are usually less common and, therefore, drugs are less useful. For 100 people, of whom 30 would vomit or feel sick after surgery if given placebo, 10 people would benefit from a drug and 90 would not. Between one to five patients out of every 100 people may experience a mild side effect, such as sedation or headache, when given an antiemetic drug. Collaborative research should focus on determining whether antiemetic drugs cause more severe, probably rare, side effects. Further comparison of the antiemetic effect of one drug versus another is not a research priority.
Conflict of interest statement
None known.
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References
References to studies included in this review
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References to studies excluded from this review
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- Eberhart LH, Mauch M, Morin AM, Wulf H, Geldner G. Impact of a multimodal anti‐emetic prophylaxis on patient satisfaction in high‐risk patients for postoperative nausea and vomiting. Anaesthesia 2002 Oct;57(10):1022‐7. [MEDLINE: ] - PubMed
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