We have located links that may give you full text access.
Comparative Study
Journal Article
Meta-Analysis
Review
Systematic Review
Total intravenous anaesthesia versus single-drug pharmacological antiemetic prophylaxis in adults: A systematic review and meta-analysis.
European Journal of Anaesthesiology 2016 October
BACKGROUND: Postoperative nausea and vomiting (PONV) are among the most unfavourable anaesthetic outcomes attributed to the administration of inhaled anaesthetics. Accordingly, inhaled anaesthetics are frequently substituted by propofol when patients are at risk of PONV. As, on some occasions, inhalational anaesthesia may be favourable, the relative impact of propofol anaesthesia needs to be established based on robust data.
OBJECTIVE: To compare the effectiveness of a single-drug pharmacological prophylaxis with total intravenous anaesthesia (TIVA) for prevention of PONV.
DESIGN: Systematic review of randomised controlled trials with meta-analyses.
DATA SOURCES: All available studies until 29 April 2015 were retrieved from MEDLINE, CENTRAL and EMBASE.
ELIGIBILITY CRITERIA: Randomised controlled trials on adult patients undergoing general anaesthesia with at least one group receiving propofol-based intravenous anaesthesia without further antiemetic prophylaxis, and one group receiving inhalational anaesthesia with single-drug antiemetic prophylaxis.
RESULTS: Fourteen studies involving 2051 patients were included. Compared with TIVA, after inhalational anaesthesia and single-drug antiemetic prophylaxis, there was no difference in the overall risk of PONV [relative risk (RR) 1.06, 95% confidence interval (CI) 0.85; 1.32, GRADE rating moderate], nor was there any difference in the risk of postoperative vomiting (RR 1.17, 95% CI 0.78; 1.76), need for rescue medication (RR 1.16, 95% CI 0.68; 1.99) or early PONV (RR 1.06, 95% CI 0.88; 1.27). However, TIVA was associated with an increased risk of late PONV (RR 1.41, 95% CI 1.10; 1.79, P = 0.006). Six studies investigated other side-effects associated with anaesthesia and found no differences between the two groups. Finally, there was evidence of a publication bias that included smaller studies favouring TIVA.
CONCLUSION: This meta-analysis confirms the results from indirect comparisons in individual studies: instead of substituting inhalational anaesthesia with propofol-based TIVA, a similar antiemetic effect can be achieved by adding single-drug pharmacological prophylaxis to the inhalational anaesthetic.
STUDY REGISTRATION: This systematic review with meta-analysis was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO), study number CRD42015019571.
OBJECTIVE: To compare the effectiveness of a single-drug pharmacological prophylaxis with total intravenous anaesthesia (TIVA) for prevention of PONV.
DESIGN: Systematic review of randomised controlled trials with meta-analyses.
DATA SOURCES: All available studies until 29 April 2015 were retrieved from MEDLINE, CENTRAL and EMBASE.
ELIGIBILITY CRITERIA: Randomised controlled trials on adult patients undergoing general anaesthesia with at least one group receiving propofol-based intravenous anaesthesia without further antiemetic prophylaxis, and one group receiving inhalational anaesthesia with single-drug antiemetic prophylaxis.
RESULTS: Fourteen studies involving 2051 patients were included. Compared with TIVA, after inhalational anaesthesia and single-drug antiemetic prophylaxis, there was no difference in the overall risk of PONV [relative risk (RR) 1.06, 95% confidence interval (CI) 0.85; 1.32, GRADE rating moderate], nor was there any difference in the risk of postoperative vomiting (RR 1.17, 95% CI 0.78; 1.76), need for rescue medication (RR 1.16, 95% CI 0.68; 1.99) or early PONV (RR 1.06, 95% CI 0.88; 1.27). However, TIVA was associated with an increased risk of late PONV (RR 1.41, 95% CI 1.10; 1.79, P = 0.006). Six studies investigated other side-effects associated with anaesthesia and found no differences between the two groups. Finally, there was evidence of a publication bias that included smaller studies favouring TIVA.
CONCLUSION: This meta-analysis confirms the results from indirect comparisons in individual studies: instead of substituting inhalational anaesthesia with propofol-based TIVA, a similar antiemetic effect can be achieved by adding single-drug pharmacological prophylaxis to the inhalational anaesthetic.
STUDY REGISTRATION: This systematic review with meta-analysis was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO), study number CRD42015019571.
Full text links
Related Resources
Trending Papers
Interstitial Lung Disease: A Review.JAMA 2024 April 23
Review article: Recent advances in ascites and acute kidney injury management in cirrhosis.Alimentary Pharmacology & Therapeutics 2024 March 26
Executive Summary: State-of-the-Art Review: Unintended Consequences: Risk of Opportunistic Infections Associated with Long-term Glucocorticoid Therapies in Adults.Clinical Infectious Diseases 2024 April 11
Clinical practice guidelines on the management of status epilepticus in adults: A systematic review.Epilepsia 2024 April 13
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app