Evaluation of the effective drugs for the prevention of nausea and vomiting induced by morphine used for postoperative pain: A quantitative systematic review

Postoperative nausea and vomiting (PONV) with morphine therapy develops in more than 60% of patients after surgery, markedly reducing patient QOL. The prophylactic effect of several antiemetics has already been studied, but e valuations, and even those using the same drug, are not uniform. The presen t research involved a meta-analysis of randomized controlled trials on prop hylactic drug therapy for PONV in patients receiving morphine for the treat ment of postoperative pain. The efficacy of the prophylactic administration of the drugs was examined. As a result, meta-analysis of five drugs was possible and the evidence of e fficacy was shown for three drugs ranked in order of an increasing odds rat io (OR) and confidence interval (CI): dexamethasone (OR: 0.23, 95 % CI: 0.1 5-0.35, p<0.00001), droperidol (OR: 0.27, 95% CI: 0.21-0.34, p<0.00001), an d metoclopramide (OR: 0.48, 95% CI: 0.30 -0.75, p<0.001). These results sug gest that the three drugs are effective in prophylactic treatment for PONV. Of them, dexamethasone used as a prophylactic drug for PONV provided the b est results. Dexamethasone was shown to reduce the incidence of PONV from 6 6-80% to 16-50% with a dose of 1.25 to 10 mg and to be suitable as a first drug of choice.