Document Detail


Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies.
MedLine Citation:
PMID:  9135299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have analysed randomized controlled studies which reported the incidence of postoperative nausea and vomiting (PONV) after propofol anaesthesia compared with other anaesthetics (control). Cumulative data of early (0-6 h) and late (0-48 h) PONV were recorded as occurrence or non-occurrence of nausea or vomiting. Combined odds ratio and number-needed-to-treat were calculated for propofol as an induction or maintenance regimen, early or late outcomes, and different emetic events. This was performed for all control event rates and within a range of 20-60% control event rates. We analysed 84 studies involving 6069 patients. The effect of propofol on PONV was dependent mainly on the method of administration, time of measurement and range of control event rates. When all studies were included the number-needed-to-treat to prevent PONV with propofol was more than 9 when used for induction of anaesthesia and at best 6 when used for maintenance. Within the 20-60% control event rate range, best results were achieved with propofol maintenance to prevent early PONV: the number-needed-to-treat to prevent early nausea was 4.7 (95% confidence interval 3.8-6.3), vomiting 4.9 (4-6.1) and any emetic event 4.9 (3.7-7.1). Within the 20-60% control event rate, of five patients treated with propofol for maintenance of anaesthesia, one will not vomit or be nauseated in the immediate postoperative period who would otherwise have vomited or been nauseated. This may be clinically relevant. In all other situations the difference between propofol and control may have reached statistical significance but was of doubtful clinical relevance. Treatment efficacy should be established within a defined range of control event rates for meaningful estimates of efficacy and for comparisons.
Authors:
M Tramèr; A Moore; H McQuay
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  78     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-05-15     Completed Date:  1997-05-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  247-55     Citation Subset:  IM    
Affiliation:
Nuffield Department of Anaesthetics, The Churchill, Oxford Radcliffe Hospital, Headington.
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Intravenous / therapeutic use*
Antiemetics / therapeutic use*
Humans
Nausea / prevention & control*
Postoperative Complications / prevention & control*
Postoperative Period
Propofol / therapeutic use*
Randomized Controlled Trials as Topic
Vomiting / prevention & control*
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 0/Antiemetics; 2078-54-8/Propofol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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