Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis

Weibel, Stephanie; Rücker, Gerta; Eberhart, Leopold; Pace, Nathan L.; Hartl, Hannah M; Jordan, Olivia; Mayer, Debora; Riemer, Manuel; Schaefer, Maximilian S.; Raj, Diana; Backhaus, Insa; Helf, Antonia; Schlesinger, Tobias; Kienbaum, Peter; Kranke, Peter

doi:10.1002/14651858.cd012859.pub2

Cited by 79 publications

(110 citation statements)

References 1,066 publications

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“…In fact, they are one major component of the so-called “triple prophylactic antiemetic therapy”, along with one of the above-described 5-HT 3 receptor antagonists plus dexamethasone [ 50 , 51 , 52 , 60 ]. Basic studies have indicated that NK 1 R antagonists behave as broad-spectrum antiemetic [ 61 ] and are also effective against postoperative nausea and vomiting in the clinic [ 62 , 63 ]; however, they are not recommended in patients on birth control medications, since aprepitant reduces the effectiveness of oral contraceptives [ 59 ].…”

Section: Diverse Stimuli Evoke Vomiting Via Distinct Receptorsmentioning

confidence: 99%

Mechanisms of Nausea and Vomiting: Current Knowledge and Recent Advances in Intracellular Emetic Signaling Systems

Zhong

Shahbaz

Teskey

et al. 2021

IJMS

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Nausea and vomiting are common gastrointestinal complaints that can be triggered by diverse emetic stimuli through central and/or peripheral nervous systems. Both nausea and vomiting are considered as defense mechanisms when threatening toxins/drugs/bacteria/viruses/fungi enter the body either via the enteral (e.g., the gastrointestinal tract) or parenteral routes, including the blood, skin, and respiratory systems. While vomiting is the act of forceful removal of gastrointestinal contents, nausea is believed to be a subjective sensation that is more difficult to study in nonhuman species. In this review, the authors discuss the anatomical structures, neurotransmitters/mediators, and corresponding receptors, as well as intracellular emetic signaling pathways involved in the processes of nausea and vomiting in diverse animal models as well as humans. While blockade of emetic receptors in the prevention of vomiting is fairly well understood, the potential of new classes of antiemetics altering postreceptor signal transduction mechanisms is currently evolving, which is also reviewed. Finally, future directions within the field will be discussed in terms of important questions that remain to be resolved and advances in technology that may help provide potential answers.

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Section: Diverse Stimuli Evoke Vomiting Via Distinct Receptorsmentioning

confidence: 99%

Mechanisms of Nausea and Vomiting: Current Knowledge and Recent Advances in Intracellular Emetic Signaling Systems

Zhong

Shahbaz

Teskey

et al. 2021

IJMS

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show abstract

“…Dexamethasone plays a very important role in regulating systemic and local inflammatory responses due to its powerful role in stabilizing the endothelium. Many studies have shown [ 17 ] that dexamethasone plays a very effective role in preventing PONV and CINV. Liu et al [ 18 ] reported that dexamethasone could significantly reduce the incidence of POV in postoperative and few adverse effects were reported.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety analysis of dexamethasone-lipiodol emulsion in prevention of post-embolization syndrome after TACE: a retrospective analysis

Zheng

Liang

et al. 2021

BMC Gastroenterol

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Background To investigate the efficacy and safety of dexamethasone-lipiodol emulsion in the prevention of post-embolization syndrome after TACE. Method The data of 255 patients who underwent TACE in the interventional department from June 2017 to June 2020 were collected. This is a retrospective assessment of patients who were non-randomly treated with dexamethasone in TACE. The patients were divided into two groups: TACE using lipiodol + chemotherapeutic emulsion group (TACE group, N = 133); TACE using lipiodol + dexamethasone + chemotherapeutic emulsion group (TACE + dexamethasone group, N = 122). Primary study endpoint: incidence of abdominal pain, fever, nausea and vomiting 0–72 h after TACE in both groups. Secondary study endpoints: incidence of infection after TACE in both groups. Results Incidence of post-embolization syndrome after TACE (TACE group vs TACE + dexamethasone group): abdominal pain, 55.6% versus 36.1% (P value 0.002); fever, 37.6% versus 13.1% (P value 0.000); nausea, 60.9% versus 41.0% (P value 0.001); vomiting, 48.1% versus 21.3% (P value 0.000). Incidence of infection after TACE (TACE group vs TACE + dexamethasone group): 1.5% versus 2.5% (P value 0.583). Conclusion The lipiodol + dexamethasone emulsion can significantly reduce the incidence rate of post-embolization syndrome after TACE, with exact effect and high safety.

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“…Nausea, vomiting, and dizziness are very distressing for patients and may lead to serious consequences. 20 According to the included RCTs, bradycardia and hypotension could be promptly treated by intravenous drugs. If surgeries are performed under spinal anesthesia, sedation caused by clonidine is beneficial for the patients.…”

Section: Discussionmentioning

confidence: 99%

Clonidine versus tramadol for post spinal anesthesia shivering

Wang

Zhao

et al. 2021

SMJ

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Objectives: To compare clonidine with tramadol for shivering control following spinal anesthesia. Methods: The literature was searched updated to August 2020, and only randomized controlled trials comparing clonidine and tramadol for shivering control following spinal anesthesia were eligible for this study. Results: Fourteen studies with 960 patients were identified. Clonidine demonstrated a lower effective rate of shivering control (OR: 0.59; 95% CI: 0.40-0.88; p =0.009; I 2 =36%), but with decreased occurrence of nausea, vomiting, and dizziness. Clonidine increased the occurrence of bradycardia, hypotension, and sedation compared to tramadol. Conclusion: Tramadol is more effective for shivering control than clonidine, but with increased occurrence of nausea, vomiting, and dizziness. PROSPERO No: CRD42020207979

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Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis

Cited by 79 publications

References 1,066 publications

Mechanisms of Nausea and Vomiting: Current Knowledge and Recent Advances in Intracellular Emetic Signaling Systems

Mechanisms of Nausea and Vomiting: Current Knowledge and Recent Advances in Intracellular Emetic Signaling Systems

Efficacy and safety analysis of dexamethasone-lipiodol emulsion in prevention of post-embolization syndrome after TACE: a retrospective analysis

Clonidine versus tramadol for post spinal anesthesia shivering

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