Cochrane · systematic review · CD012859
Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta‐analysis
Weibel, S, Rücker, G, Eberhart, LHJ, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
AnaesthesiaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
319
current version
GRADE rated
129
No studies
55
Included studies
NR
No studies 55 · 17.2%Ungraded 135 · 42.3%Very low 64 · 20.1%Low 49 · 15.4%Moderate 10 · 3.1%High 6 · 1.9%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings (vomiting within 24 hours postoperatively)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: vomiting (or dry retching) within 24 hours postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 282 RCTs Total participants: 50,812 Number of treatments: 65 Geometry of the network** | no estimate extracted | 282 studies · 50812 participants | Ungraded |
Dolasetron (5 RCTs; 400 participants) | no estimate extracted | 5 studies · 400 participants | Low |
Granisetron (16 RCTs; 2270 participants) | no estimate extracted | 16 studies · 2270 participants | High |
Ondansetron (77 RCTs; 14,435 participants) | no estimate extracted | 77 studies · 14435 participants | High |
Palonosetron (6 RCTs; 1111 participants) | no estimate extracted | 6 studies · 1111 participants | Low |
Ramosetron (6 RCTs; 618 participants) | no estimate extracted | 6 studies · 618 participants | High |
Tropisetron (13 RCTs; 1275 participants) | no estimate extracted | 13 studies · 1275 participants | Low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (2 RCTs; 841 participants) | no estimate extracted | 2 studies · 841 participants | Moderate |
Droperidol (41 RCTs; 6156 participants) | no estimate extracted | 41 studies · 6156 participants | Moderate |
Haloperidol (4 RCTs; 327 participants) | no estimate extracted | 4 studies · 327 participants | Low |
Metoclopramide (21 RCTs; 2134 participants) | no estimate extracted | 21 studies · 2134 participants | Very low |
Perphenazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (1 RCT; 94 participants) | no estimate extracted | 1 study · 94 participants | High |
Casopitant (no direct evidence, indirect evidence only) | no estimate extracted | NR | Low |
Fosaprepitant (No direct evidence, indirect evidence only) | no estimate extracted | NR | Moderate |
Rolapitant (1 RCT; 515 participants) | no estimate extracted | 1 study · 515 participants | Very low |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (43 RCTs; 4804 participants) | no estimate extracted | 43 studies · 4804 participants | High |
Methylprednisolone (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (1 RCT; 56 participants) | no estimate extracted | 1 study · 56 participants | Very low |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (3 RCTs; 210 participants) | no estimate extracted | 3 studies · 210 participants | Moderate |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (6 RCTs; 549 participants) | no estimate extracted | 6 studies · 549 participants | Low |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (serious adverse events)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: serious adverse events (SAEs)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 28 RCTs Total participants: 10,766 Number of treatments: 22 Geometry of the network** | no estimate extracted | 28 studies · 10766 participants | Ungraded |
Dolasetron (3 RCTs; 1448 participants) | no estimate extracted | 3 studies · 1448 participants | Low |
Granisetron (2 RCTs; 401 participants) | no estimate extracted | 2 studies · 401 participants | Very low |
Ondansetron (3 RCTs; 833 participants) | no estimate extracted | 3 studies · 833 participants | Very low |
Palonosetron (3 RCTs; 1319 participants) | no estimate extracted | 3 studies · 1319 participants | Very low |
Ramosetron (1 RCT; 236 participants) | no estimate extracted | 1 study · 236 participants | Very low |
Tropisetron (2 RCTs; 727 participants) | no estimate extracted | 2 studies · 727 participants | Very low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (2 RCTs; 904 participants) | no estimate extracted | 2 studies · 904 participants | Low |
Droperidol (2 RCTs; 304 participants) | no estimate extracted | 2 studies · 304 participants | Low |
Haloperidol (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Metoclopramide (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perphenazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Casopitant (No direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (3 RCTs; 376 participants) | no estimate extracted | 3 studies · 376 participants | Very low |
Methylprednisolone (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (1 RCT; 174 participants) | no estimate extracted | 1 study · 174 participants | Very low |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (any adverse event)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: any adverse event (AE)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 61 RCTs Total participants: 19,423 Number of treatments: 27 Geometry of the network** | no estimate extracted | 61 studies · 19423 participants | Ungraded |
Dolasetron (1 RCT; 203 participants) | no estimate extracted | 1 study · 203 participants | Very low |
Granisetron (6 RCTs; 699 participants) | no estimate extracted | 6 studies · 699 participants | Moderate |
Ondansetron (12 RCTs; 4892 participants) | no estimate extracted | 12 studies · 4892 participants | Low |
Palonosetron (2 RCTs; 946 participants) | no estimate extracted | 2 studies · 946 participants | Low |
Ramosetron (2 RCTs; 173 participants) | no estimate extracted | 2 studies · 173 participants | Very low |
Tropisetron (3 RCTs; 1007 participants) | no estimate extracted | 3 studies · 1007 participants | Low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (2 RCTs; 904 participants) | no estimate extracted | 2 studies · 904 participants | Moderate |
Droperidol (2 RCTs; 1622 participants) | no estimate extracted | 2 studies · 1622 participants | Low |
Haloperidol (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Metoclopramide (3 RCTs; 853 participants) | no estimate extracted | 3 studies · 853 participants | Low |
Perphenazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Casopitant (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (6 RCTs; 1152 participants) | no estimate extracted | 6 studies · 1152 participants | Low |
Methylprednisolone (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (no direct evidence, indirect evidence only) | no estimate extracted | NR | Low |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (3 RCTs; 273 participants) | no estimate extracted | 3 studies · 273 participants | Low |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (headache)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: headache within 7 days postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 208 RCTs Total participants: 42,445 Number of treatments: 53 Geometry of the network** | no estimate extracted | 208 studies · 42445 participants | Ungraded |
Dolasetron (10 RCTs; 3990 participants) | no estimate extracted | 10 studies · 3990 participants | Low |
Granisetron (15 RCTs; 1639 participants) | no estimate extracted | 15 studies · 1639 participants | Very low |
Ondansetron (57 RCTs; 12260 participants) | no estimate extracted | 57 studies · 12260 participants | Moderate |
Palonosetron (7 RCTs; 1259 participants) | no estimate extracted | 7 studies · 1259 participants | Very low |
Ramosetron (14 RCTs; 1529 participants) | no estimate extracted | 14 studies · 1529 participants | Low |
Tropisetron (10 RCTs; 1656 participants) | no estimate extracted | 10 studies · 1656 participants | Low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (2 RCTs; 904 participants) | no estimate extracted | 2 studies · 904 participants | Low |
Droperidol (22 RCTs; 3679 participants) | no estimate extracted | 22 studies · 3679 participants | Moderate |
Haloperidol (2 RCTs; 99 participants) | no estimate extracted | 2 studies · 99 participants | Low |
Metoclopramide (11 RCTs; 1313 participants) | no estimate extracted | 11 studies · 1313 participants | Very low |
Perphenazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (1 RCT; 120 participants) | no estimate extracted | 1 study · 120 participants | Low |
Casopitant (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (13 RCTs; 1678 participants) | no estimate extracted | 13 studies · 1678 participants | Low |
Methylprednisolone (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (1 RCT; 50 participants) | no estimate extracted | 1 study · 50 participants | Very low |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (1 RCT; 50 participants) | no estimate extracted | 1 study · 50 participants | Very low |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (4 RCTs; 447 participants) | no estimate extracted | 4 studies · 447 participants | Very low |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (sedation)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: sedation within 7 days postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 117 RCTs Total participants: 21,440 Number of treatments: 44 Geometry of the network** | no estimate extracted | 117 studies · 21440 participants | Ungraded |
Dolasetron (5 RCTs; 2402 participants) | no estimate extracted | 5 studies · 2402 participants | Low |
Granisetron (9 RCTs; 850 participants) | no estimate extracted | 9 studies · 850 participants | Very low |
Ondansetron (36 RCTs; 6092 participants) | no estimate extracted | 36 studies · 6092 participants | Moderate |
Palonosetron (2 RCTs; 278 participants) | no estimate extracted | 2 studies · 278 participants | Very low |
Ramosetron (5 RCTs; 581 participants) | no estimate extracted | 5 studies · 581 participants | Low |
Tropisetron (2 RCTs; 98 participants) | no estimate extracted | 2 studies · 98 participants | Low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (1 RCT; 689 participants) | no estimate extracted | 1 study · 689 participants | Low |
Droperidol (21 RCTs; 3739 participants) | no estimate extracted | 21 studies · 3739 participants | Low |
Haloperidol (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Metoclopramide (15 RCTs; 1178 participants) | no estimate extracted | 15 studies · 1178 participants | Very low |
Perphenazine (1 RCT; 115 participants) | no estimate extracted | 1 study · 115 participants | Very low |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Casopitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (9 RCTs; 1290 participants) | no estimate extracted | 9 studies · 1290 participants | High |
Methylprednisolone (1 RCT; 112 participants) | no estimate extracted | 1 study · 112 participants | Low |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (1 RCT; 50 participants) | no estimate extracted | 1 study · 50 participants | Moderate |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (3 RCTs; 162 participants) | no estimate extracted | 3 studies · 162 participants | Very low |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (4 RCTs; 204 participants) | no estimate extracted | 4 studies · 204 participants | Very low |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (extrapyramidal symptoms)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: extrapyramidal symptoms within 7 days postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 64 RCTs Total participants: 10,724 Number of treatments: 30 Geometry of the network** | no estimate extracted | 64 studies · 10724 participants | Ungraded |
Dolasetron (3 RCTs; 288 participants) | no estimate extracted | 3 studies · 288 participants | Low |
Granisetron (5 RCTs; 330 participants) | no estimate extracted | 5 studies · 330 participants | Very low |
Ondansetron (7 RCTs; 751 participants) | no estimate extracted | 7 studies · 751 participants | Very low |
Palonosetron (1 RCT; 60 participants) | no estimate extracted | 1 study · 60 participants | Very low |
Ramosetron (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Tropisetron (3 RCTs; 187 participants) | no estimate extracted | 3 studies · 187 participants | Very low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (1 RCT; 689 participants) | no estimate extracted | 1 study · 689 participants | Low |
Droperidol (22 RCTs; 3270 participants) | no estimate extracted | 22 studies · 3270 participants | Low |
Haloperidol (5 RCTs; 437 participants) | no estimate extracted | 5 studies · 437 participants | Low |
Metoclopramide (12 RCTs; 855 participants) | no estimate extracted | 12 studies · 855 participants | Low |
Perphenazine (1 RCT; 115 participants) | no estimate extracted | 1 study · 115 participants | Very low |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Casopitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (4 RCTs; 1031 participants) | no estimate extracted | 4 studies · 1031 participants | Low |
Methylprednisolone (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (constipation)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: constipation within 7 days postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 43 RCTs Total participants: 11,481 Number of treatments: 23 Geometry of the network** | no estimate extracted | 43 studies · 11481 participants | Ungraded |
Dolasetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Granisetron (3 RCTs; 230 participants) | no estimate extracted | 3 studies · 230 participants | Very low |
Ondansetron (8 RCTs; 1475 participants) | no estimate extracted | 8 studies · 1475 participants | Very low |
Palonosetron (3 RCTs; 1437 participants) | no estimate extracted | 3 studies · 1437 participants | Very low |
Ramosetron (2 RCTs; 280 participants) | no estimate extracted | 2 studies · 280 participants | Very low |
Tropisetron (2 RCTs; 226 participants) | no estimate extracted | 2 studies · 226 participants | Very low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (2 RCTs; 904 participants) | no estimate extracted | 2 studies · 904 participants | Very low |
Droperidol (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Haloperidol (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Metoclopramide (1 RCT; 80 participants) | no estimate extracted | 1 study · 80 participants | Low |
Perphenazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Casopitant (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (3 RCTs; 327 participants) | no estimate extracted | 3 studies · 327 participants | Low |
Methylprednisolone (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (postoperative wound infection)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: wound infection within 7 days postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 32 RCTs Total participants: 4369 Number of treatments: 10 Geometry of the network** | no estimate extracted | 32 studies · 4369 participants | Ungraded |
Dolasetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Granisetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Ondansetron (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Palonosetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Ramosetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Tropisetron (1 RCT; 156 participants) | no estimate extracted | 1 study · 156 participants | Low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Droperidol (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Haloperidol (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Metoclopramide (1 RCT; 104 participants) | no estimate extracted | 1 study · 104 participants | Very low |
Perphenazine (0 RCT; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Casopitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (24 RCTs; 3199 participants) | no estimate extracted | 24 studies · 3199 participants | Very low |
Methylprednisolone (1 RCT; 40 participants) | no estimate extracted | 1 study · 40 participants | Very low |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (arrhythmia)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: arrhythmia within 7 days postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 25 RCTs Total participants: 5067 Number of treatments: 18 Geometry of the network** | no estimate extracted | 25 studies · 5067 participants | Ungraded |
Dolasetron (2 RCTs; 1184 participants) | no estimate extracted | 2 studies · 1184 participants | Low |
Granisetron (1 RCT; 50 participants) | no estimate extracted | 1 study · 50 participants | Very low |
Ondansetron (4 RCTs; 1643 participants) | no estimate extracted | 4 studies · 1643 participants | Very low |
Palonosetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Ramosetron (1 RCT; 140 participants) | no estimate extracted | 1 study · 140 participants | Low |
Tropisetron (1 RCT; 50 participants) | no estimate extracted | 1 study · 50 participants | Very low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Droperidol (7 RCTs; 659 participants) | no estimate extracted | 7 studies · 659 participants | Very low |
Haloperidol (2 RCTs; 99 participants) | no estimate extracted | 2 studies · 99 participants | Very low |
Metoclopramide (3 RCTs; 150 participants) | no estimate extracted | 3 studies · 150 participants | Very low |
Perphenazine (0 RCTs 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Casopitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (3 RCTs; 189 participants) | no estimate extracted | 3 studies · 189 participants | Low |
Methylprednisolone (1 RCT; 96 participants) | no estimate extracted | 1 study · 96 participants | Very low |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (visual disturbances)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: visual disturbances within 7 days postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 21 RCTs Total participants: 3634 Number of treatments: 12 Geometry of the network** | no estimate extracted | 21 studies · 3634 participants | Ungraded |
Dolasetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Granisetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Ondansetron (3 RCTs; 506 participants) | no estimate extracted | 3 studies · 506 participants | Low |
Palonosetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Ramosetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Tropisetron (1 RCT; 97 participants) | no estimate extracted | 1 study · 97 participants | Very low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Droperidol (5 RCTs; 682 participants) | no estimate extracted | 5 studies · 682 participants | Very low |
Haloperidol (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Metoclopramide (1 RCT; 100 participants) | no estimate extracted | 1 study · 100 participants | Low |
Perphenazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Casopitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (1 RCT; 40 participants) | no estimate extracted | 1 study · 40 participants | Low |
Methylprednisolone (1 RCT; 96 participants) | no estimate extracted | 1 study · 96 participants | Very low |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (8 RCTs; 683 participants) | no estimate extracted | 8 studies · 683 participants | Low |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |
Summary of findings (QT prolongation)
Population: adults undergoing any type of surgery under general anaesthesia Interventions: antiemetic drugs (monoprophylaxis and combination prophylaxis)* Comparator (reference): placebo (or no treatment) Outcome: QT prolongation within 7 days postoperatively
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total studies: 18 RCTs Total participants: 4440 Number of treatments: 13 Geometry of the network** | no estimate extracted | 18 studies · 4440 participants | Ungraded |
Dolasetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Granisetron (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Ondansetron (1 RCT; 60 participants) | no estimate extracted | 1 study · 60 participants | Low |
Palonosetron (1 RCT; 546 participants) | no estimate extracted | 1 study · 546 participants | Very low |
Ramosetron (no direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Tropisetron (1 RCT; 385 participants) | no estimate extracted | 1 study · 385 participants | Very low |
D2 receptor antagonists | no estimate extracted | 2 participants | Ungraded |
Amisulpride (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Droperidol (3 RCTs; 303 participants) | no estimate extracted | 3 studies · 303 participants | Low |
Haloperidol (4 RCTs; 338 participants) | no estimate extracted | 4 studies · 338 participants | Low |
Metoclopramide (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perphenazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
NK1 receptor antagonists | no estimate extracted | 1 participants | Ungraded |
Aprepitant (nNo direct evidence, indirect evidence only) | no estimate extracted | NR | Very low |
Casopitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Fosaprepitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Rolapitant (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Corticosteroids | no estimate extracted | NR | No studies |
Dexamethasone (1 RCT; 149 participants) | no estimate extracted | 1 study · 149 participants | Very low |
Methylprednisolone (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Antihistamines | no estimate extracted | NR | No studies |
Dimenhydrinate (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Meclizine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Promethazine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Anticholinergics | no estimate extracted | NR | No studies |
Scopolamine (0 RCTs; 0 participants) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Comparator | no estimate extracted | NR | No studies |
Placebo | no estimate extracted | NR | No studies |