Drugs for preventing postoperative nausea and vomiting

Carlisle, J. B.; Stevenson, Carl A

doi:10.1002/14651858.cd004125.pub2

Cited by 227 publications

(152 citation statements)

References 580 publications

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“…5HT3 antagonists remain the first-line therapy due to their good side effect profile. Lowdose dexamethasone improves liver regeneration (with no additional benefit at higher doses) [115]. As dexamethasone can worsen glycemic control, it should be used with caution in diabetics.…”

Section: Analgesiamentioning

confidence: 99%

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Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background Enhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus. Methods A systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations. Results A total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal-directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization are recommended. There is no evidence to prefer epidural to other types of analgesia. Conclusions The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.

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Section: Analgesiamentioning

confidence: 99%

“…As dexamethasone can worsen glycemic control, it should be used with caution in diabetics. Other secondary drugs are antihistamines, butyrophenones and phenothiazines [115]. According to the recommendations from the international consensus group on PONV, 2 antiemetic drugs are advocated to reduce postoperative PONV [116].…”

Section: Analgesiamentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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“…It has been reported that at least one in each four patients suffers from PONV [1] [2]. Then, the prevention and treatment of nausea and vomiting have become important subjects in anesthesiology [3]. Currently, even with new anesthetic techniques, which involve the use of prophylactic agents and the selection of anesthetics with lower emetic potentials, the incidence of PONV has not decreased and is still approximately 20% to 30% [4] [5] [6].…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial Comparing the Efficacy of P6 Acupuncture Plus Ondansetron versus Ondansetron or P6 Acupuncture in the Prevention of Nausea and Vomiting after Bupivacaine-Morphine Spinal Anesthesia

Yin¹,

Bráz²,

Colares³

et al. 2017

OJAnes

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Objective: To compare P6 acupuncture plus ondansetron with either ondansetron or P6 acupuncture in the prevention of postoperative nausea and vomiting (PONV) in patients submitted to spinal anesthesia. Methods: A randomized controlled trial was performed with 90 patients undergoing orthopedic surgery under spinal anesthesia with bupivacaine, 15 to 17.5 mg, and morphine, 100 μg. They were assigned to one of the three groups: Group Ondansetron (n = 30), patients were given ondansetron, 8 mg intravenously, before spinal block was performed; Group P6 acupuncture (n = 30), patients were subjected to bilateral electrical stimulation of P6 acupoint for 30 minutes before anesthesia; and Group P6 acupuncture plus ondansetron (n = 30), the exact combination of the groups Ondansetron and P6 acupuncture. Results: In the post anesthesia care unit, the incidence of nausea and vomiting ranged from 13.3% to 26.7% and from 6.7% to 13.3%, respectively, with no significant differences among groups (p > 0.05). Ondansetron group had the highest incidence of nausea (73.3%) (p < 0.001) and vomiting (43.3%) (p < 0.001) at the ward from 0 to 24 hours, followed by P6 acupuncture (33.3% and 26.7%) and P6 acupuncture plus ondansetron groups (16.0% and 0%). Conclusion: Preoperative stimulation of P6 acupoint in combination with ondansetron has higher efficacy than either P6 acupoint stimulation or the administration of

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“…droperidol at any dose reduced the relative risk (RR) of PONV by 38% (RR 0.62, 95% confidence interval 0.58-0.67) [20]. In a general surgical population, droperidol 0.625 mg administered 30 min before the end of anaesthesia reduced the incidence of PONV to 7%, compared with 41% for placebo [21].…”

Section: Qtc and Anaesthesiamentioning

confidence: 99%

“…Ondansetron, dexamethasone and droperidol each reduced the relative risk of PONV by about 26% [23]. However a superior antinausea effect for droperidol 1.25 mg in comparison with ondansetron 4 mg has been reported [24] and noted in guidelines [6,20].…”

Section: Qtc and Anaesthesiamentioning

confidence: 99%

Droperidol: past, present and future

Sneyd¹

2009

Anaesthesia

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Drugs for preventing postoperative nausea and vomiting

Cited by 227 publications

References 580 publications

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

A Randomized Controlled Trial Comparing the Efficacy of P6 Acupuncture Plus Ondansetron versus Ondansetron or P6 Acupuncture in the Prevention of Nausea and Vomiting after Bupivacaine-Morphine Spinal Anesthesia

Droperidol: past, present and future

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