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Prophylactic ondansetron for postoperative emesis.Meta‐analysis of its effectiveness in patients with previous history of postoperative nausea and vomiting
Author(s) -
Figueredo E.,
Canosa L.
Publication year - 1999
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.1999.430608.x
Subject(s) - ondansetron , medicine , antiemetic , postoperative nausea and vomiting , vomiting , anesthesia , nausea , placebo , droperidol , surgery , alternative medicine , pathology
Background: The objective of this study was to compare, by means of meta‐analysis, the postoperative antiemetic efficacy of ondansetron in patients with and without antecedents of postoperative nausea and vomiting. Methods: MEDLINE and EMBASE databases were searched for randomised placebo‐controlled trials which evaluated the antiemetic effectiveness of 4 mg and 8 mg intravenous doses of prophylactic ondansetron in adult patients. A further selection was with respect to those studies which noted the patient's previous history of postoperative nausea and vomiting (PH‐PONV) and, for the meta‐analysis, the patients were divided into two sub‐groups: those with (PH‐PONV +) and those without a previous history of postoperative nausea and vomiting (PH‐PONV −). Absence of vomiting was used as the index of effectiveness. Results: Twenty‐one trials involving 3984 patients (2446 in ondansetron groups and 1538 in placebo groups; 1163 PH‐PONV(+) patients and 2821 PH‐PONV(−) patients) met the selection criteria. The effectiveness of the 4 mg dose of ondansetron was: OR (95% CI)=2.40 (1.77–3.26) vs. 2.71 (2.23–3.30) for the patients of PH‐PONV(+) and PH‐PONV(−) sub‐groups, respectively. For the 8 mg dose, the effectiveness of ondansetron was: PH‐PONV(+)=4.21 (2.66–6.66) and PH‐PONV(−)=2.61 (1.81–3.59). For neither of the doses evaluated was there any significant statistical difference between the sub‐groups. Conclusions: The effectiveness of ondansetron in the prevention of postoperative vomiting is not affected by the patients’ PH‐PONV.