The Efficacy and Safety of Transdermal Scopolamine for the Prevention of Postoperative Nausea and Vomiting: A Quantitative Systematic Review

@article{Kranke2002TheEA,
  title={The Efficacy and Safety of Transdermal Scopolamine for the Prevention of Postoperative Nausea and Vomiting: A Quantitative Systematic Review},
  author={Peter Kranke and Astrid M. Morin and Norbert Roewer and Hinnerk F. Wulf and Leopold H. J. Eberhart},
  journal={Anesthesia \& Analgesia},
  year={2002},
  volume={95},
  pages={133-143}
}
The role of scopolamine administered via transdermal therapeutic systems in the prevention of postoperative vomiting, nausea, and nausea and vomiting is unclear. We performed a systematic search for full reports of randomized comparisons of transdermal scopolamine with inactive control. Dichotomous data were extracted. In the meta-analysis, relative risks and numbers-needed-to-treat/harm were calculated with 95% confidence intervals (CI). In 23 trials, 979 patients received transdermal… 
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The combination of transdermal scopolamine in combination with IV ondansetron reduces PONV compared with OND alone, and this is achieved with a reduction in adverse events.
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Olanzapine reduced nausea and vomiting in the 24 h after hospital discharge from ambulatory surgery by about 60% with a slight increase in reported sedation, corresponding to a number-needed-to-treat of just four patients.
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TLDR
Transdermal scopolamine is easy to administer, safe, effective, and relatively cost-effective, and it should be considered as an important tool to help prevent PONV/PDNV, whether administered as monotherapy or in combination with other agent(s).
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