Abstract | BACKGROUND: OBJECTIVE: METHODS: PubMed and the Cochrane Library were searched for randomized controlled, double-blind studies measuring efficacy in terms of PONV prophylaxis. A Bayesian meta-analysis was conducted using published studies of 5-HT(3) antagonists for PONV prophylaxis. The odds of patients with no PONV and postoperative vomiting (POV) within each study arm 24 hours after surgery were the primary indices of drug efficacy. Data were extracted and analyzed via indirect comparisons using random effects Bayesian models in WinBUGS version 1.4.3. RESULTS: A total of 85 studies were identified, representing 15,269 patients. The results indicate that granisetron was significantly better than ondansetron (odds ratio [OR] = 1.53 [95% credible interval (CI), 1.15-2.00]) and dolasetron (OR = 1.67 [95% CI, 1.12-2.38]) in preventing PONV. Four antiemetic drugs had comparable efficacy in terms of preventing POV: granisetron showed similar efficacy compared with ondansetron (OR = 1.49 [95% CI, 0.90-2.43]), tropisetron (OR = 1.69 [95% CI, 0.92-3.13]), and dolasetron (OR = 1.32 [95% CI, 0.71-2.38]). Ondansetron exhibited comparable efficacy compared with tropisetron (OR = 1.14 [95% CI, 0.66-1.96]) and dolasetron (OR = 0.88 [95% CI, 0.51-1.47]). Tropisetron and dolasetron were also similar in efficacy (OR = 0.78 [95% CI, 0.40-1.45]). All 5-HT(3) antagonists were statistically significantly better at preventing PONV or POV than placebo. CONCLUSIONS:
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Authors | Derek H Tang, Daniel C Malone |
Journal | Clinical therapeutics
(Clin Ther)
Vol. 34
Issue 2
Pg. 282-94
(Feb 2012)
ISSN: 1879-114X [Electronic] United States |
PMID | 22296947
(Publication Type: Journal Article, Meta-Analysis)
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Copyright | Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved. |
Chemical References |
- Serotonin 5-HT3 Receptor Antagonists
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Topics |
- Adult
- Humans
- Postoperative Nausea and Vomiting
(prevention & control)
- Randomized Controlled Trials as Topic
- Serotonin 5-HT3 Receptor Antagonists
(therapeutic use)
- Time Factors
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