Hailu Seyoum, Mekonen Semagn, Shiferaw Adanech
Department of Anesthesiology, Dilla University, Ethiopia.
Ann Med Surg (Lond). 2022 Mar 8;75:103433. doi: 10.1016/j.amsu.2022.103433. eCollection 2022 Mar.
Post-operative nausea and vomiting (PONV) are a common post-operative problem in anesthesia. The incidence of PONV in patients undergoing cesarean sections is very high. Post-operative nausea and vomiting have many negative impacts on the patient, baby, family, and health care system. Therefore, appropriate evidence-based knowledge regarding the prevention and management of PONV for those high-risk patients is a timely and very important issue to address to decrease the associated complications.
A comprehensive literature search was conducted in Pubmed/Medline, Cochrane reviews, and google scholar including those studies published in the English language from 2010 up to 2021. The methodological quality of the included studies was appraised by the Cochrane risk of a biased assessment tool for intervention and non-interventional studies.
The search strategy identified a total of 10,540 articles from different electronic databases. 33 articles were selected for screening after duplicates were removed; finally, 17 articles were included for critical appraisal and 16 articles were excluded with reasons. The included articles consist of 15 RCT, 1 non-control prospective cohort, and 1 cross-sectional study.
Pieces of evidence revealed that all obstetrics patients undergoing cesarean section should be given multimodal PONV prophylaxis. It is shown that a multimodal approach by a combination of different antiemetic agents should be preferred and most effective in preventing intraoperative and postoperative nausea and vomiting for patients undergoing cesarean section because of the complex pathophysiology of nausea and vomiting.
术后恶心呕吐（PONV）是麻醉中常见的术后问题。剖宫产患者中PONV的发生率非常高。术后恶心呕吐对患者、婴儿、家庭和医疗保健系统都有许多负面影响。因此，为这些高危患者提供有关PONV预防和管理的适当循证知识，是减少相关并发症需要及时解决的非常重要的问题。
在Pubmed/Medline、Cochrane综述和谷歌学术上进行了全面的文献检索，包括2010年至2021年以英文发表的那些研究。纳入研究的方法学质量通过Cochrane干预性和非干预性研究偏倚评估工具进行评估。
检索策略从不同的电子数据库中总共识别出10540篇文章。去除重复项后，选择33篇文章进行筛选；最后，纳入17篇文章进行批判性评价，16篇文章因各种原因被排除。纳入的文章包括15项随机对照试验、1项非对照前瞻性队列研究和1项横断面研究。
证据表明，所有接受剖宫产的产科患者都应接受多模式PONV预防。结果显示，由于恶心和呕吐的病理生理机制复杂，联合使用不同的止吐药物的多模式方法在预防剖宫产患者术中及术后恶心呕吐方面应是首选且最有效的。
