Dimenhydrinate for prophylaxis of postoperative nausea and vomiting: a meta‐analysis of randomized controlled trials

@article{Kranke2002DimenhydrinateFP,
  title={Dimenhydrinate for prophylaxis of postoperative nausea and vomiting: a meta‐analysis of randomized controlled trials},
  author={Peter Kranke and Astrid M. Morin and Norbert Roewer and Leopold H. J. Eberhart},
  journal={Acta Anaesthesiologica Scandinavica},
  year={2002},
  volume={46}
}
Background: Diphenhydramine and its theoclate salt dimenhydrinate are traditional antiemetics still in use. However, so far the quantitative effect of dimenhydrinate in the prophylaxis of postoperative nausea and vomiting (PONV) has not been evaluated systematically. 

Pharmacology of Postoperative Nausea and Vomiting

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The evidence for the implementation of PONV protocols within an enhanced recovery after surgery program (ERP) is summarized to address the following: identifying high-risk patients, minimizing risks, administering appropriate prophylactic antiemetic and rescue treatment, and recommending a treatment algorithm for use in an ERP protocol.

Patients’ willingness to pay for anti‐emetic treatment

TLDR
This study was conducted in 100 German and Turkish patients scheduled for elective surgery under general anaesthesia to assess the amount patients were willing to pay for an anti‐emetic that completely prevented PONV.

Prophylaxis of Postoperative Nausea and Vomiting with Oral, Long-Acting Dimenhydrinate in Gynecologic Outpatient Laparoscopy

TLDR
Preoperative administration of an oral dose of LA dimenhydrinate in combination with droperidol when compared with dro peridol alone effectively reduced the incidence of vomiting but not nausea in women undergoing elective outpatient gynecologic laparoscopy.

Pharmacotherapy of postoperative nausea and vomiting

TLDR
The risk factors and physiology of PonV, currently available therapies, the use of a multimodal approach and the cost-effectiveness of PONV management are discussed.

Strategies for postoperative nausea and vomiting.

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Prophylactic administration of ginger and ondansetron significantly reduced the incidence of postoperative nausea and vomiting compared to ondANSetron alone in patients undergoing day care surgery under general anaesthesia.

A COMPARATIVE STUDY BETWEEN PALONOSETRON AND GRANISETRON TO PREVENT POSTOPERATIVE NAUSEA AND VOMITING AFTER MIDDLE EAR SURGERY

TLDR
Prophylactic therapy with palonosetron is more effective than granisetron for long term prevention of postoperative nausea and vomiting after middle ear surgery.
...

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A small dose of droperidol decreases postoperative nausea and vomiting in adults but cannot improve an already excellent patient satisfaction

TLDR
A routine prophylaxis with 20 μg  ·  kg−1 body weight of droperidol would efficiently prevent postoperative nausea and vomiting after elective surgery in adults and an efficient proplylaxis would improve patient satisfaction is evaluated.

The Use of Nonpharmacologic Techniques to Prevent Postoperative Nausea and Vomiting

TLDR
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TLDR
A meta‐analysis on granisetron in the prevention of postoperative nausea and vomiting (PONV) and whether total results and the dose–response characteristics may be significantly affected by a single centre is performed.

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TLDR
Droperidol and 5‐HT3‐receptor antagonists are among the most potent antiemetics to prevent postoperative nausea and vomiting (PONV) and the quantitative effect of this combination has not been evaluated systematically.

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TLDR
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TLDR
Intra-operative dimenhydrinate, followed by three further administrations after surgery, reduces the incidence and the severity of post-operative nausea and vomiting without side effects.

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TLDR
The high incidence of PONV after BMF can be explained by the greater invasiveness of BMF than R&R surgery, and can be reduced by preoperative administration of dimenhydrinate suppositories.

Rectally administered dimenhydrinate reduces postoperative vomiting in children after strabismus surgery.

TLDR
It is concluded that rectal administration of dimenhydrinate is an effective means of reducing postoperative vomiting in children undergoing strabismus surgery.

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TLDR
It was showed that nonpharmacologic techniques were equivalent to commonly used antiemetic drugs in preventing vomiting after surgery and may be an alternative to receiving no treatment or first-line antiemetics.

Dimenhydrinate and metoclopramide alone or in combination for prophylaxis of PONV

TLDR
Dimenhydrinate and metoclopramide were ineffective in reducing the incidence and the severity of PONV and their combination reduced the incidence of PonV compared with placebo.
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