METAANALYTIC COMPARISON OF PROPHYLACTIC ANTIEMETIC EFFICACY FOR POSTOPERATIVE NAUSEA AND VOMITING - PROPOFOL ANESTHESIA VS OMITTING NITROUS-OXIDE VS TOTAL IV ANESTHESIA WITH PROPOFOL
M. Tramer et al., METAANALYTIC COMPARISON OF PROPHYLACTIC ANTIEMETIC EFFICACY FOR POSTOPERATIVE NAUSEA AND VOMITING - PROPOFOL ANESTHESIA VS OMITTING NITROUS-OXIDE VS TOTAL IV ANESTHESIA WITH PROPOFOL, British Journal of Anaesthesia, 78(3), 1997, pp. 256-259
Data from two published and one new metaanalysis were reviewed to comp
are the antiemetic efficacy of three different anaesthetic regimens: (
i) propofol anaesthesia compared with another anaesthetic (control); (
ii) anaesthesia without nitrous oxide compared with the same anaesthet
ic with nitrous oxide (control); (iii) propofol anaesthesia without ni
trous oxide (TIVA) compared with another anaesthetic with nitrous oxid
e (control). Efficacy (prevention of postoperative nausea and vomiting
compared with control) was estimated using odds ratio and number-need
ed-to-treat methods, and compared within a range of 20-60% control eve
nt rates for early efficacy (0-6 h) and 40-80% for late efficacy (0-48
h). Propofol anaesthesia or omitting nitrous oxide had similar effect
s on vomiting, both early and late. Propofol (but not omitting nitrous
oxide) decreased the incidence of nausea. TIVA studies were documente
d poorly; appropriate comparisons with other interventions were not po
ssible. Efficacy of treatments should be compared within a setting-spe
cific range of control event rates. There is insufficient evidence tha
t TIVA with propofol is an anaesthetic technique with a low emetogenic
potency.