Preventing postoperative nausea and vomiting: post hoc analysis of pooled data from two randomized active-controlled trials of aprepitant

Background Postoperative nausea and vomiting are important causes of morbidity after general anesthesia. Nitrous oxide has been implicated as an emetogenic agent in many studies. However, several other trials have failed to sustain this claim. The authors tried to resolve this issue through a meta-analysis of randomized controlled trials comparing the incidence of postoperative nausea and vomiting after anesthesia with or without nitrous oxide. Methods Of 37 published studies retrieved by a search of articles indexed on the MEDLINE database from 1966 to 1994, 24 studies (26 trials) with distinct nitrous-oxide and non-nitrous oxide groups were eligible for the meta-analysis. The pooled odds ratio and relative risk were calculated. Post boc subgroup analysis was also performed to qualify the result. Results The pooled odds ratio was 0.63 (0.53 to 0.75). Omission of nitrous oxide reduced the risk for postoperative nausea and vomiting by 28% (18% to 37%). In the subgroup analysis, the maximal effect of omission of nitrous oxide was seen in female patients. In patients undergoing abdominal surgery and general surgical procedures, the effect of omission of nitrous oxide, although in the same direction, was not significant. Conclusion Omission of nitrous oxide reduced the odds of postoperative nausea and vomiting by 37%, a reduction in risk of 28%.

Download Full-text

Does Supplemental Oxygen Reduce Postoperative Nausea and Vomiting? A Meta-Analysis of Randomized, Controlled Trials

Survey of Anesthesiology ◽

10.1097/01.sa.0000318695.50109.8d ◽

2009 ◽

Vol 53 (1) ◽

pp. 31-32

Author(s):

&NA;

Keyword(s):

Randomized Controlled Trials ◽

Postoperative Nausea ◽

Meta Analysis ◽

Postoperative Nausea And Vomiting ◽

Supplemental Oxygen ◽

Nausea And Vomiting ◽

Controlled Trials ◽

Randomized Controlled

Download Full-text

Comparison of Ondansetron and Dexamethasone for Prophylaxis of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Surgeries: A Meta-Analysis of Randomized Controlled Trials

Anesthesiology Research and Practice ◽

10.1155/2016/7089454 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Souvik Maitra ◽

Anirban Som ◽

Dalim K. Baidya ◽

Sulagna Bhattacharjee

Keyword(s):

Postoperative Nausea ◽

Randomized Trials ◽

Meta Analysis ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Controlled Trials ◽

Postoperative Vomiting ◽

Pubmed Central ◽

Randomized Controlled ◽

Equal Efficacy

Background.Postoperative nausea and vomiting (PONV) is a significant complication after laparoscopic surgeries. Ondansetron and dexamethasone are most commonly used drugs for PONV prophylaxis. Comparisons of these two drugs have not been systematically reviewed till date.Methods.PubMed, PubMed Central, and CENTRAL databases were searched with the following words: “dexamethasone,” “ondansetron,” “laparoscopy,” and “PONV” to identify randomized trials that compared ondansetron and dexamethasone for PONV prophylaxis after laparoscopic surgeries.Results.Data of 592 patients from 7 RCTs have been included in this meta-analysis. Incidence of postoperative nausea at 4–6 h is significantly lower when dexamethasone was used instead of ondansetron (p=0.04; OR 0.49, 95% CI 0.24–0.98, M-H fixed). Incidence of nausea is similar at 24 hours (p=0.08, OR 0.71, 95% CI 0.48, 1.05; M-H fixed); vomiting is also similar at 4–6 h (p=0.43, OR 1.27, 95% CI 0.70–2.27; M-H fixed) and also at 24 h (p=0.46, OR 0.92, 95% CI 0.73, 1.16; M-H fixed).Conclusion.Dexamethasone is superior to ondansetron in preventing postoperative nausea after 4–6 h of laparoscopic surgeries. However, both the drugs are of equal efficacy in preventing postoperative vomiting up to 24 h after surgery. However, results should be interpreted with caution due to clinical heterogeneity in the included studies.

Download Full-text