Prevention of vomiting after paediatric strabismus surgery: a systematic review using the numbers-needed-to-treat method.

Abstract

Randomized controlled studies were reviewed to assess the effectiveness and safety of antiemetics used for prophylaxis in paediatric strabismus surgery. Early and late vomiting (6 and 48 h after operation, respectively), and adverse effects were evaluated using the numbers-needed-to-treat method. In 27 reports with information on 2033 children, the mean incidence of early vomiting was 54% and of late vomiting 59%, without prophylaxis. Only three drugs were studied sufficiently for firm conclusions to be drawn. In the best documented regimen (droperidol 75 micrograms kg-1), four children have to be given the drug to prevent one vomiting; of the three others, one may vomit and two would not have vomited anyway; fewer than one child in 100 may have an extrapyramidal reaction and 16 may have minor adverse effects. Metoclopramide 0.15 and 0.25 mg kg-1 was significantly better than control only for early vomiting. Propofol had a high incidence of oculocardiac reflex without conferring any significant antiemetic effect: it should not be used. The benefits of prophylactic antiemetic therapy are not proven.

• Authors: M Tramèr, A Moore, H McQuay
• Journal: British journal of anaesthesia (Br J Anaesth) Vol. 75 Issue 5 Pg. 556-61 (Nov 1995) ISSN: 0007-0912 [Print] England
• PMID: 7577280 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review, Systematic Review)

Chemical References

• Antiemetics
• Droperidol
• Propofol

Topics

• Antiemetics (therapeutic use)
• Child
• Droperidol (therapeutic use)
• Humans
• Postoperative Complications (prevention & control)
• Propofol (therapeutic use)
• Randomized Controlled Trials as Topic
• Strabismus (surgery)
• Vomiting (prevention & control)