Abstract | OBJECTIVE: DATA SOURCES: We searched 4 bibliographic databases, conference proceedings, reference lists of articles and textbooks, and contacted experts in the field of anesthesia and hepatobiliary surgery. REVIEW METHODS: We evaluated the methodologic quality of trials and extracted data regarding baseline characteristics, interventions, and outcomes. We pooled results from the studies using a random-effects model, evaluated the degree of heterogeneity, and explored potential explanations for heterogeneity. RESULTS: Seventeen trials met eligibility criteria and provided high quality evidence regarding steroid effectiveness. Irrespective of the co-interventions (other antiemetic medications), dexamethasone reduced the incidence of nausea (RR 0.59, 95% CI, 0.48-0.72), vomiting (RR 0.41, 95% CI, 0.30-0.55), and postoperative nausea or vomiting (RR 0.55, 95% CI, 0.44-0.67) relative to placebo. Dexamethasone also seemed to reduce the severity of postoperative pain (Ratio of Means 0.87, 95% CI, 0.78-0.98), although substantial unexplained heterogeneity was present (I 90.4%). The incidence of headache and dizziness was similar between groups. CONCLUSIONS:
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Authors | Paul J Karanicolas, Shona E Smith, Bilge Kanbur, Edward Davies, Gordon H Guyatt |
Journal | Annals of surgery
(Ann Surg)
Vol. 248
Issue 5
Pg. 751-62
(Nov 2008)
ISSN: 1528-1140 [Electronic] United States |
PMID | 18948802
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Chemical References |
- Antiemetics
- Glucocorticoids
- Dexamethasone
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Topics |
- Antiemetics
(therapeutic use)
- Cholecystectomy, Laparoscopic
- Dexamethasone
(therapeutic use)
- Glucocorticoids
(therapeutic use)
- Humans
- Pain, Postoperative
(prevention & control)
- Postoperative Nausea and Vomiting
(prevention & control)
- Randomized Controlled Trials as Topic
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