Drugs for preventing postoperative nausea and vomiting in adults after general anesthesia: An abridged Cochrane network meta-analysis.


Journal

Journal of evidence-based medicine
ISSN: 1756-5391
Titre abrégé: J Evid Based Med
Pays: England
ID NLM: 101497477

Informations de publication

Date de publication:
Sep 2021
Historique:
revised: 08 02 2021
received: 18 12 2020
accepted: 10 04 2021
pubmed: 28 5 2021
medline: 29 10 2021
entrez: 27 5 2021
Statut: ppublish

Résumé

In this abridged version of the recently published Cochrane review on antiemetic drugs, we summarize its most important findings and discuss the challenges and the time needed to prepare what is now the largest Cochrane review with network meta-analysis in terms of the number of included studies and pages in its full printed form. We conducted a systematic review with network meta-analyses to compare and rank single antiemetic drugs and their combinations belonging to 5HT₃-, D₂-, NK₁-receptor antagonists, corticosteroids, antihistamines, and anticholinergics used to prevent postoperative nausea and vomiting in adults after general anesthesia. 585 studies (97 516 participants) testing 44 single drugs and 51 drug combinations were included. The studies' overall risk of bias was assessed as low in only 27% of the studies. In 282 studies, 29 out of 36 drug combinations and 10 out of 28 single drugs lowered the risk of vomiting at least 20% compared to placebo. In the ranking of treatments, combinations of drugs were generally more effective than single drugs. Single NK There is high or moderate evidence for at least seven single drugs preventing postoperative vomiting. However, there is still considerable lack of evidence regarding safety aspects that does warrant investigation.

Identifiants

pubmed: 34043870
doi: 10.1111/jebm.12429
doi:

Substances chimiques

Antiemetics 0
Pharmaceutical Preparations 0

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

188-197

Informations de copyright

© 2021 The Authors. Journal of Evidence-Based Medicine published by Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Références

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Auteurs

Stephanie Weibel (S)

Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.

Nathan L Pace (NL)

Department of Anesthesiology, University of Utah, Salt Lake City, Utah, USA.

Maximilian S Schaefer (MS)

Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Department of Anaesthesiology, University Hospital Duesseldorf, Duesseldorf, Germany.

Diana Raj (D)

Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Queen Elizabeth University Hospital, Glasgow, UK.

Tobias Schlesinger (T)

Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.

Patrick Meybohm (P)

Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.

Peter Kienbaum (P)

Department of Anaesthesiology, University Hospital Duesseldorf, Duesseldorf, Germany.

Leopold H J Eberhart (LHJ)

Department of Anaesthesiology & Intensive Care Medicine, Philipps-University Marburg, Marburg, Germany.

Peter Kranke (P)

Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.

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