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Titolo:
EFFICACY, DOSE-RESPONSE, AND SAFETY OF ONDANSETRON IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING - A QUANTITATIVE SYSTEMATIC REVIEW OFRANDOMIZED PLACEBO-CONTROLLED TRIALS
Autore:
TRAMER MR; REYNOLDS JM; PHIL D; MOORE RA; MCQUAY HJ;
Indirizzi:
UNIV HOSP GENEVA,DAPSIC,DIV ANESTHESIOL,RUE MICHELI DU CREST 24 CH-1211 GENEVA 14 SWITZERLAND OXFORD RADCLIFFE HOSP,NUFFIELD DEPT ANAESTHET,PAIN RES UNIT OXFORD ENGLAND OXFORD RADCLIFFE HOSP,DEPT CLIN PHARMACOL OXFORD ENGLAND
Titolo Testata:
Anesthesiology
fascicolo: 6, volume: 87, anno: 1997,
pagine: 1277 - 1289
SICI:
0003-3022(1997)87:6<1277:EDASOO>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROPHYLACTIC ANTIEMETIC THERAPY; DOUBLE-BLIND; ORAL ONDANSETRON; GYNECOLOGICAL LAPAROSCOPY; INTRAVENOUS ONDANSETRON; GENERAL-ANESTHESIA; AMBULATORY SURGERY; PEDIATRIC-PATIENTS; CLINICAL-TRIALS; META-ANALYSIS;
Keywords:
ANTIEMETICS, ONDANSETRON; POSTOPERATIVE COMPLICATIONS, NAUSEA, VOMITING; STATISTICS AND EPIDEMIOLOGY, SYSTEMATIC REVIEW, METAANALYSIS, NUMBER-NEEDED-TO-TREAT;
Tipo documento:
Article
Natura:
Periodico
Citazioni:
80
Recensione:
Indirizzi per estratti:
Citazione:
M.R. Tramer et al., "EFFICACY, DOSE-RESPONSE, AND SAFETY OF ONDANSETRON IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING - A QUANTITATIVE SYSTEMATIC REVIEW OFRANDOMIZED PLACEBO-CONTROLLED TRIALS", Anesthesiology, 87(6), 1997, pp. 1277-1289

Abstract

Objective: The authors reviewed efficacy and safety data for ondansetron for preventing postoperative nausea and vomiting (PONV), Methods: Systematically searched, randomized, controlled trials (obtained through MEDLINE, EMBASE, Biological Abstracts, manufacturer's database, manual searching of journals, and article reference Lists) were analyzed,Relevant end points were prevention of early PONV (within 6 h after surgery) and late PONV (within 48 h) and adverse effects. Relative benefit and number-needed-to-treat were calculated. The number-needed-to-treat indicated how many patients had to be exposed to ondansetron to prevent PONV in one of them who would have vomited or been nauseated had he or she received placebo. Results: Fifty-three trials were found that had data from 7,177 patients receiving 24 different ondansetron regimens and from 5,712 controls receiving placebo or no treatment. Average early and late PONV incidences without ondansetron were 40% and 60%, respectively. There was a dose response for oral and intravenous ondansetron. Best number-needed-to-treat to prevent PONV with the best documented regimens was between 5 and 6. This was achieved with an intravenous dose of 8 mg and an oral dose of 16 mg. Antivomiting efficacy was consistently better than antinausea efficacy, Efficacy in childrenwas poorly documented. Ondansetron significantly increased the risk for elevated liver enzymes (number-needed-to-harm was 31) and headache (number-needed-to-harm was 36). Conclusions: If the risk of PONV is very high, for every 100 patients receiving an adequate dose of ondansetron 20 patients will not vomit who would have vomited had they received placebo, The antinausea effect is less pronounced. Of these 100, three will have elevated liver enzymes and three will have a headache whowould not have had these adverse effects without the drug.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/09/20 alle ore 13:40:35