Background
Methods
Data sources and search strategy
Study selection
Data extraction
Assessment of study quality
Assessment of risk of bias
Statistical analysis
Results
Identification of eligible studies
Study characteristics
Study | No. of patients (dexamethasone/ondansetron) | Patient characteristics | Jadad score | Type of anaesthesia | Intra-abdominal pressure |
---|---|---|---|---|---|
D’souza N et al. | 61(30/31) | Adult patients undergoing laparoscopic gynaecologic surgery | 4 | General | 10-14 mmHg |
Ashwani K et al. | 160(80/80) | Adult patients undergoing laparoscopic cholecystectomy | 4 | General | None |
Erhan Y et al. | 40(20/20) | Adult patients undergoing laparoscopic cholecystectomy | 4 | General | 12 mmHg |
Gautan B et al. | 95(47/48) | Adult patients undergoing laparoscopic cholecystectomy | 5 | General | Below 15 mmHg |
Aighanem SM et al. | 120(60/60) | Adult patients undergoing laparoscopic cholecystectomy | 5 | General | 10-16 cm of water |
Mohammad E et al. | 92(46/46) | Adult patients undergoing laparoscopic cholecystectomy | 5 | General | Below 15 mmHg |
Yuksek MS et al. | 40(20/20) | Adult patients undergoing laparoscopic gynaecologic surgery | 4 | Combined general epidural anaesthesia | 12-18 mmHg |
Meta-analyses of primary outcomes
Postoperative nausea and vomiting (0–24 h)
Postoperative nausea and vomiting at different stages
Meta-analyses of secondary outcomes (0–24 h)
Quality assessment and quality of evidence
No. of patients | Effect | Quality | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
NO. of studies | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Dexamethasone | Ondansetron | Relative(95 % CI) | Absolute | |
7 | No serious risk of bias | No serious inconsistency | No serious indirectness | Serious | None | 101/303(33.3 %) | 112/305(36.7 %) | RR 0.91(0.72-1.12) | 33 fewer per 1000 (from 103 fewer to 44 more) | MODERATE |
5 | No serious risk of bias | No serious inconsistency | No serious indirectness | Serious | None | 47/163(28.8 %) | 39/165(23.6 %) | RR 1.25(0.84-1.76) | 59 more per 1000 (from 38 fewer to 180 more) | MODERATE |
5 | No serious risk of bias | No serious inconsistency | No serious indirectness | Serious | None | 13/163(8 %) | 26/165(15.8 %) | RR 0.48(0.25-0.92) | 82 fewer per 1000 (from 13 fewer to 118 more) | MODERATE |
7 | No serious risk of bias | No serious inconsistency | No serious indirectness | Serious | None | 65/303(21.5 %) | 73/305(23.9 %) | RR 0.89(0.64-1.19) | 26 fewer per 1000 (from 86 fewer to 45 more) | MODERATE |
Power analysis
PONV(0–24 h) | PONV (0–6 h) | PONV (6–24 h) | Anti-emetics used (0–24 h) | |
---|---|---|---|---|
Ashwani K et al. | 10.30 % | NA | NA | 10.30 % |
Gautan B et al. | 5.10 % | 57 % | 45.30 % | 5.50 % |
Mohammad E et al. | 6.90 % | 42.40 % | 64 % | 8.50 % |
Yuksek MS et al. | 24.20 % | 24.20 % | NA | 14.10 % |
D’souza N et al. | 28.70 % | 28.70 % | NA | 23.60 % |
Alghanem SM et al. | 5.20 % | NA | NA | 7.10 % |
Erhan Y et al. | 10.50 % | 20.20 % | 18 % | 6.60 % |
All studies | 12.20 % | 17.90 % | 64 % | 9.10 % |