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Comparative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis.
Anesth Analg. 1999 Jun; 88(6):1370-9.A&A

Abstract

Postoperative nausea and vomiting are important causes of morbidity after anesthesia and surgery. We performed a meta-analysis of published, randomized, controlled trials to determine the relative efficacy and safety of ondansetron, droperidol, and metoclopramide for the prevention of postoperative nausea and vomiting. We performed a literature search of English references using both the MEDLINE database and a manual search. Double-blinded, randomized, controlled trials comparing the efficiency of the prophylactic administration of ondansetron, droperidol, and/or metoclopramide therapy during general anesthesia were included. A total of 58 studies were identified, of which 4 were excluded for methodological concerns. For each comparison of drugs, a pooled odds ratio (OR) with a 95% CI was calculated using a random effects model. Ondansetron (pooled OR 0.43, 95% CI 0.31, 0.61; P < 0.001) and droperidol (pooled OR 0.68, 95% CI 0.54, 0.85; P < 0.001) were more effective than metoclopramide in preventing vomiting. Ondansetron was more effective than droperidol in preventing vomiting in children (pooled OR 0.49; P = 0.004), but they were equally effective in adults (pooled OR 0.87; P = 0.45). The overall risk of adverse effects was not different among drug combinations. We conclude that ondansetron and droperidol are more effective than metoclopramide in reducing postoperative vomiting.

IMPLICATIONS

We performed a systematic review of published, randomized, controlled trials to determine the relative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting. Ondansetron and droperidol were more effective than metoclopramide in reducing postoperative vomiting. The overall risk of adverse effects did not differ.

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Authors+Show Affiliations

Domino KB
Department of Anesthesiology, University of Washington School of Medicine, Seattle, USA. kdomino@u.washington.edu
Anderson EA
No affiliation info available
Polissar NL
No affiliation info available
Posner KL
No affiliation info available

MeSH

AdultAntiemeticsChildDroperidolFemaleHumansMaleMetoclopramideOndansetronPostoperative Nausea and VomitingRandomized Controlled Trials as Topic

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

10357347

Citation

Domino, K B., et al. "Comparative Efficacy and Safety of Ondansetron, Droperidol, and Metoclopramide for Preventing Postoperative Nausea and Vomiting: a Meta-analysis." Anesthesia and Analgesia, vol. 88, no. 6, 1999, pp. 1370-9.
Domino KB, Anderson EA, Polissar NL, et al. Comparative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis. Anesth Analg. 1999;88(6):1370-9.
Domino, K. B., Anderson, E. A., Polissar, N. L., & Posner, K. L. (1999). Comparative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis. Anesthesia and Analgesia, 88(6), 1370-9.
Domino KB, et al. Comparative Efficacy and Safety of Ondansetron, Droperidol, and Metoclopramide for Preventing Postoperative Nausea and Vomiting: a Meta-analysis. Anesth Analg. 1999;88(6):1370-9. PubMed PMID: 10357347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis. AU - Domino,K B, AU - Anderson,E A, AU - Polissar,N L, AU - Posner,K L, PY - 1999/6/5/pubmed PY - 1999/6/5/medline PY - 1999/6/5/entrez SP - 1370 EP - 9 JF - Anesthesia and analgesia JO - Anesth Analg VL - 88 IS - 6 N2 - UNLABELLED: Postoperative nausea and vomiting are important causes of morbidity after anesthesia and surgery. We performed a meta-analysis of published, randomized, controlled trials to determine the relative efficacy and safety of ondansetron, droperidol, and metoclopramide for the prevention of postoperative nausea and vomiting. We performed a literature search of English references using both the MEDLINE database and a manual search. Double-blinded, randomized, controlled trials comparing the efficiency of the prophylactic administration of ondansetron, droperidol, and/or metoclopramide therapy during general anesthesia were included. A total of 58 studies were identified, of which 4 were excluded for methodological concerns. For each comparison of drugs, a pooled odds ratio (OR) with a 95% CI was calculated using a random effects model. Ondansetron (pooled OR 0.43, 95% CI 0.31, 0.61; P < 0.001) and droperidol (pooled OR 0.68, 95% CI 0.54, 0.85; P < 0.001) were more effective than metoclopramide in preventing vomiting. Ondansetron was more effective than droperidol in preventing vomiting in children (pooled OR 0.49; P = 0.004), but they were equally effective in adults (pooled OR 0.87; P = 0.45). The overall risk of adverse effects was not different among drug combinations. We conclude that ondansetron and droperidol are more effective than metoclopramide in reducing postoperative vomiting. IMPLICATIONS: We performed a systematic review of published, randomized, controlled trials to determine the relative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting. Ondansetron and droperidol were more effective than metoclopramide in reducing postoperative vomiting. The overall risk of adverse effects did not differ. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/10357347/Comparative_efficacy_and_safety_of_ondansetron_droperidol_and_metoclopramide_for_preventing_postoperative_nausea_and_vomiting:_a_meta_analysis_ L2 - https://doi.org/10.1097/00000539-199906000-00032 DB - PRIME DP - Unbound Medicine ER -
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