Comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section: A network meta-analysis
Background: Antiemetic medications have been associated with the prevention of nausea and vomiting in cesarean section, although less is known about the comparative efficacy of different medication classes. Methods: We conducted a systematic review with network meta-analyses to compare and rank anti...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | International Journal of Preventive Medicine |
| Subjects: | |
| Online Access: | http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2023;volume=14;issue=1;spage=116;epage=116;aulast=Asgarlou |
| _version_ | 1827309083632336896 |
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| author | Zoleykha Asgarlou Elham Dehghanpour Mohammadian Sousan Houshmandi Mohammad Mohseni Sepideh Gareh Sheyklo Ahmad Moosavi Shiler Ahmadi |
| author_facet | Zoleykha Asgarlou Elham Dehghanpour Mohammadian Sousan Houshmandi Mohammad Mohseni Sepideh Gareh Sheyklo Ahmad Moosavi Shiler Ahmadi |
| author_sort | Zoleykha Asgarlou |
| collection | DOAJ |
| description | Background: Antiemetic medications have been associated with the prevention of nausea and vomiting in cesarean section, although less is known about the comparative efficacy of different medication classes. Methods: We conducted a systematic review with network meta-analyses to compare and rank antiemetic medication classes (5-HT3 receptor antagonists, dopamine receptor antagonists, corticosteroids, antihistamines, anticholinergic agents, sedatives, and opioid antagonists or partial agonists) in terms of preventing intra- and postoperative nausea and vomiting among patients undergoing cesarean section. We included all randomized controlled trials (RCTs) that evaluated any antiemetic medication classes' treatment for target outcomes. Network meta-analysis was conducted with a frequentist approach using the R netmeta package. A total of 58 trials were included (6,665 women undergoing cesarean section; mean age, 28.1 years). Results: Compared with placebo, all interventions reduced the odds of intraoperative nausea (except antihistamines), intraoperative vomiting (except antihistamines), postoperative nausea (except anticholinergic agents and opioid antagonists), and postoperative vomiting (except opioid antagonists). In terms of intraoperative nausea and both intra- and postoperative vomiting, sedatives ranked first among other medication classes. Conclusions: The relative effect sizes for various classes of antiemetic medication in preventing nausea and vomiting in the cesarean section were modeled using the principles of network meta-analysis which may facilitate informed clinical decision-making. |
| first_indexed | 2024-03-11T15:44:11Z |
| format | Article |
| id | doaj.art-79cc1124e6174987a9e9e898ec455479 |
| institution | Directory Open Access Journal |
| issn | 2008-7802 2008-8213 |
| language | English |
| last_indexed | 2024-04-24T19:25:20Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | International Journal of Preventive Medicine |
| spelling | doaj.art-79cc1124e6174987a9e9e898ec4554792024-03-25T15:46:00ZengWolters Kluwer Medknow PublicationsInternational Journal of Preventive Medicine2008-78022008-82132023-01-0114111611610.4103/ijpvm.ijpvm_250_22Comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section: A network meta-analysisZoleykha AsgarlouElham Dehghanpour MohammadianSousan HoushmandiMohammad MohseniSepideh Gareh SheykloAhmad MoosaviShiler AhmadiBackground: Antiemetic medications have been associated with the prevention of nausea and vomiting in cesarean section, although less is known about the comparative efficacy of different medication classes. Methods: We conducted a systematic review with network meta-analyses to compare and rank antiemetic medication classes (5-HT3 receptor antagonists, dopamine receptor antagonists, corticosteroids, antihistamines, anticholinergic agents, sedatives, and opioid antagonists or partial agonists) in terms of preventing intra- and postoperative nausea and vomiting among patients undergoing cesarean section. We included all randomized controlled trials (RCTs) that evaluated any antiemetic medication classes' treatment for target outcomes. Network meta-analysis was conducted with a frequentist approach using the R netmeta package. A total of 58 trials were included (6,665 women undergoing cesarean section; mean age, 28.1 years). Results: Compared with placebo, all interventions reduced the odds of intraoperative nausea (except antihistamines), intraoperative vomiting (except antihistamines), postoperative nausea (except anticholinergic agents and opioid antagonists), and postoperative vomiting (except opioid antagonists). In terms of intraoperative nausea and both intra- and postoperative vomiting, sedatives ranked first among other medication classes. Conclusions: The relative effect sizes for various classes of antiemetic medication in preventing nausea and vomiting in the cesarean section were modeled using the principles of network meta-analysis which may facilitate informed clinical decision-making.http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2023;volume=14;issue=1;spage=116;epage=116;aulast=Asgarlouantiemeticscesarean sectionnausea and vomitingnetwork meta-analysis |
| spellingShingle | Zoleykha Asgarlou Elham Dehghanpour Mohammadian Sousan Houshmandi Mohammad Mohseni Sepideh Gareh Sheyklo Ahmad Moosavi Shiler Ahmadi Comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section: A network meta-analysis International Journal of Preventive Medicine antiemetics cesarean section nausea and vomiting network meta-analysis |
| title | Comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section: A network meta-analysis |
| title_full | Comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section: A network meta-analysis |
| title_fullStr | Comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section: A network meta-analysis |
| title_full_unstemmed | Comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section: A network meta-analysis |
| title_short | Comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section: A network meta-analysis |
| title_sort | comparative efficacy of different classes of antiemetic medications for the prevention of nausea and vomiting in cesarean section a network meta analysis |
| topic | antiemetics cesarean section nausea and vomiting network meta-analysis |
| url | http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2023;volume=14;issue=1;spage=116;epage=116;aulast=Asgarlou |
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