Cox Lalage, Darvill Emily, Dorman Saskie
St Peter's Hospice, Brentry, Bristol, UK.
Cochrane Database Syst Rev. 2015 Nov 2;2015(11):CD009420. doi: 10.1002/14651858.CD009420.pub3.
This is an updated version of the original Cochrane Review published in Issue 4, 2013, on Levomepromazine for nausea and vomiting in palliative care.Nausea and vomiting are common, distressing symptoms for patients receiving palliative care. There are several drugs which can be used to treat these symptoms, known as antiemetics. Levomepromazine is an antipsychotic drug is commonly used as an antiemetic to alleviate nausea and vomiting in palliative care settings.
To evaluate the efficacy of, and adverse events associated with, levomepromazine for the treatment of nausea and vomiting in palliative care patients.
For this update we searched electronic databases, including those of Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, up to February 2015. We searched clinical trial registers on 7 October 2015 for ongoing trials.
Randomised controlled trials of levomepromazine for the treatment of nausea or vomiting, or both, in adults receiving palliative care. We excluded studies in which symptoms were thought to be due to pregnancy or surgery.
We assessed the potential relevance of studies based on titles and abstracts. We obtained copies of any study reports that appeared to meet the inclusion criteria for further assessment. At least two review authors read each paper to determine suitability for inclusion and discussed discrepancies in order to achieve a consensus.
In the original review, we identified 421 abstracts using the search strategy. We considered eight studies for inclusion but ultimately excluded them all from the review. We updated the search in February 2015 and identified 35 abstracts, but again none met the inclusion criteria. We identified two trials from clinical trial registers, one of which is ongoing and one of which was closed due to poor recruitment.
AUTHORS' CONCLUSIONS: As in the initial review, we identified no published randomised controlled trials examining the use of levomepromazine for the management of nausea and vomiting in adults receiving palliative care, and our conclusion (that further studies of levomepromazine and other antiemetic agents are needed to provide better evidence for their use in this setting) remains unchanged. We did, however, identify one ongoing study that we hope will contribute to the evidence base for this intervention in future updates of this review.
这是2013年第4期发表的关于左美丙嗪用于姑息治疗中恶心和呕吐的原始Cochrane系统评价的更新版本。恶心和呕吐是接受姑息治疗患者常见且令人痛苦的症状。有几种药物可用于治疗这些症状，即止吐药。左美丙嗪是一种抗精神病药物，常用于姑息治疗环境中缓解恶心和呕吐。
评估左美丙嗪治疗姑息治疗患者恶心和呕吐的疗效及相关不良事件。
对于本次更新，我们检索了电子数据库，包括截至2015年2月的Cochrane对照试验中心注册库（CENTRAL）、MEDLINE和EMBASE。我们于2015年10月7日检索了临床试验注册库以查找正在进行的试验。
左美丙嗪用于治疗接受姑息治疗的成人恶心或呕吐或两者的随机对照试验。我们排除了症状被认为是由妊娠或手术引起的研究。
我们根据标题和摘要评估研究的潜在相关性。我们获取了任何似乎符合纳入标准的研究报告副本以进行进一步评估。至少两名综述作者阅读每篇论文以确定是否适合纳入，并讨论分歧以达成共识。
在原始综述中，我们使用检索策略识别了421篇摘要。我们考虑纳入8项研究，但最终将它们全部排除在综述之外。我们在2015年2月更新了检索，识别出35篇摘要，但同样没有一篇符合纳入标准。我们从临床试验注册库中识别出两项试验，其中一项正在进行，另一项因招募不佳而关闭。
与初始综述一样，我们未找到已发表的关于左美丙嗪用于治疗接受姑息治疗的成人恶心和呕吐的随机对照试验，我们的结论（即需要对左美丙嗪和其他止吐药进行进一步研究，以提供其在该环境中使用的更好证据）保持不变。然而，我们确实识别出一项正在进行的研究，我们希望它将为该综述未来更新中这种干预措施的证据基础做出贡献。
