Supplemental peri-operative intravenous crystalloids for postoperative nausea and vomiting: an abridged Cochrane systematic review

J. K. Jewer, M. J. Wong, S. J. Bird, A. S. Habib, R. Parker, R. B. George

Research output: Contribution to journalReview articlepeer-review

12 Citations (Scopus)

Abstract

We conducted a Cochrane systematic review on the effectiveness of supplemental intravenous crystalloid administration in preventing postoperative nausea and vomiting. We included randomised controlled trials of patients undergoing surgery under general anaesthesia and given supplemental peri-operative intravenous crystalloid. Our primary outcomes were the risk of postoperative nausea and the risk of postoperative vomiting. We assessed the risk of bias for each included study and applied the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework for the certainty of evidence. We included 41 studies. We found that the intervention probably reduces the overall risk of postoperative nausea, the risk ratio (95%CI) being 0.62 (0.51–0.75) (I2 = 57%, p < 0.00001, 18 studies; 1766 participants; moderate-certainty evidence). It also probably reduces the risk of postoperative nausea within 6 h of surgery, with a risk ratio (95%CI) of 0.67 (0.58 to 0.78) (I2 = 9%, p < 0.00001, 20 studies; 2310 participants; moderate-certainty evidence) and by around 24 h, the risk ratio (95%CI) being 0.47 (0.32–0.69) (I2 = 38%, p = 0.0001, 17 studies; 1682 participants; moderate-certainty evidence). Supplemental intravenous crystalloid probably also reduces the overall risk of postoperative vomiting, with a risk ratio (95%CI) of 0.50 (0.40–0.63) (I2 = 31%, p < 0.00001, 20 studies; 1970 participants; moderate-certainty evidence). The beneficial effect on vomiting was seen both within 6 h and by around 24 h postoperatively.

Original languageEnglish
Pages (from-to)254-265
Number of pages12
JournalAnaesthesia
Volume75
Issue number2
DOIs
Publication statusPublished - Feb 1 2020

Bibliographical note

Publisher Copyright:
© 2019 Association of Anaesthetists

ASJC Scopus Subject Areas

  • Anesthesiology and Pain Medicine

PubMed: MeSH publication types

  • Journal Article
  • Systematic Review

Fingerprint

Dive into the research topics of 'Supplemental peri-operative intravenous crystalloids for postoperative nausea and vomiting: an abridged Cochrane systematic review'. Together they form a unique fingerprint.

Cite this