The effect of perioperative benzodiazepine administration on postoperative nausea and vomiting: a systematic review and meta-analysis of randomised controlled trials

被引：3

作者：

Au, Emily ^{[1
]}

Zhao, Karen ^{[1
]}

Belley-Cote, Emilie ^{[2
]}

Song, Yuri ^{[3
]}

Al-Hazzani, Waleed ^{[4
,5
]}

Sadeghirad, Behnam ^{[6
,7
]}

Wang, Eugene ^{[8
]}

Young, Jack ^{[9
]}

Kashani, Hessam ^{[10
]}

Kavosh, Morvarid ^{[11
]}

Inami, Toru ^{[12
]}

Beaver, Chris ^{[13
]}

Kloppenburg, Shelley ^{[13
]}

Mazer, David ^{[14
,15
,16
]}

Jacobsohn, Eric ^{[17
]}

Um, Kevin ^{[18
]}

Spence, Jessica ^{[19
,20
]}

机构：

[1] McMaster Univ, Fac Hlth Sci, Hamilton, ON, Canada

[2] McMaster Univ, Populat Hlth Res Inst, Dept Med Cardiol & Crit Care, Perioperat Res Div, Hamilton, ON, Canada

[3] McMaster Univ, Fac Sci, Hamilton, ON, Canada

[4] McMaster Univ, Dept Crit Care, Hlth Res Methods Evaluat & Impact HEI, Hamilton, ON, Canada

[5] McMaster Univ, Dept Med Gastroenterol, Hlth Res Methods Evaluat & Impact HEI, Hamilton, ON, Canada

[6] McMaster Univ, Dept Anesthesia, Hamilton, ON, Canada

[7] McMaster Univ, Dept Hlth Res Methods Evaluat & Impact, Hamilton, ON, Canada

[8] Univ Ottawa, Dept Family Med, Ottawa, ON, Canada

[9] McMaster Univ, Hlth Sci Lib, Hamilton, ON, Canada

[10] Univ Manitoba, Dept Anesthesia & Perioperat Med, Winnipeg, MB, Canada

[11] Coney Isl Hosp, Dept Med, New York, NY USA

[12] Nippon Med Sch, Dept Cardiovasc Med, Tokyo, Japan

[13] St Michaels Hosp, Patient family partner, Toronto, ON, Canada

[14] St Michaels Hosp, Dept Anesthesia, Toronto, ON, Canada

[15] St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada

[16] Univ Toronto, Dept Anesthesiol & Pain Med, Toronto, ON, Canada

[17] Univ Manitoba, Dept Anesthesia & Perioperat Med & Med Crit Care, Winnipeg, MB, Canada

[18] McMaster Univ, Dept Med Cardiol, Hamilton, ON, Canada

[19] McMaster Univ, Populat Hlth Res Inst, Dept Anesthesia & Crit Care, Perioperat Res Div, Hamilton, ON, Canada

[20] McMaster Univ, Populat Hlth Res Inst, Dept Hlth Res Methods Evaluat & Impact, Perioperat Res Div, Hamilton, ON, Canada

来源：

BRITISH JOURNAL OF ANAESTHESIA | 2024年 / 132卷 / 03期

关键词：

benzodiazepines; meta-analysis; perioperative medicine; postoperative nausea and vomiting; systematic review; PATIENT-CONTROLLED ANALGESIA; DOUBLE-BLIND EVALUATION; INTRATHECAL MIDAZOLAM; INTRAVENOUS MIDAZOLAM; GENERAL-ANESTHESIA; SPINAL-ANESTHESIA; PREOPERATIVE-MEDICATION; ANTIEMETIC EFFICACY; ANTICIPATORY NAUSEA; REGIONAL ANESTHESIA;

D O I：

10.1016/j.bja.2023.11.045

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Background: Despite recent systematic reviews suggesting their benefit for postoperative nausea, vomiting, or both (PONV) prevention, benzodiazepines have not been incorporated into guidelines for PONV prophylaxis because of concerns about possible adverse effects. We conducted an updated meta -analysis to inform future practice guidelines. Methods: We included randomised controlled trials (RCTs) of all languages comparing benzodiazepines with nonbenzodiazepine comparators in adults undergoing inpatient surgery. Our outcomes were postoperative nausea, vomiting, or both. We assessed risk of bias for RCTs using the Cochrane Risk of Bias tool. We pooled data using a randomeffects model and assessed the quality of evidence for each outcome using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results: We screened 31 413 abstracts and 950 full texts. We included 119 RCTs; 104 were included in quantitative synthesis. Based on moderate certainty evidence, we found that perioperative benzodiazepine administration reduced the incidence of PONV (52 studies, n=5086, relative risk [RR]: 0.77, 95% confidence interval [CI] 0.66-0.89; number needed to treat [NNT] 16; moderate certainty), postoperative nausea (55 studies, n=5916, RR: 0.72, 95% CI 0.62-0.83; NNT 21; moderate certainty), and postoperative vomiting (52 studies, n=5909, RR: 0.74, 95% CI 0.60-0.91; NNT 55; moderate certainty). Conclusions: Moderate quality evidence shows that perioperative benzodiazepine administration decreases the incidence of PONV. The results of this systematic review and meta -analysis will inform future clinical practice guidelines. Systematic Review Protocol: The protocol for this systematic review was pre -registered with PROSPERO International Prospective Register of Systematic Reviews (CRD42022361088) and published in BMJ Open (PMID 31831540).

引用

页码：469 / 482

页数：14

共 141 条

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