Cavaye John, Dai Bryan, Gurunathan Karthik, Weir Rachel M, Yerkovich Stephanie, Gurunathan Usha
Faculty of Medicine, University of Queensland, Queensland, Australia.
Department of Anaesthesia and Perfusion Services, The Prince Charles Hospital, Queensland, Australia.
J Anaesthesiol Clin Pharmacol. 2022 Jan-Mar;38(1):35-47. doi: 10.4103/joacp.JOACP_464_20. Epub 2021 Nov 10.
A systematic electronic search of MEDLINE, EMBASE, and CINAHL databases aimed at comparing neurokinin-1 receptor antagonists with other antiemetics in their prevention of postoperative nausea and vomiting in adult patients undergoing laparoscopic surgery identified seven randomized controlled trials for review and meta-analysis. Preoperative aprepitant 80 mg was found to reduce nausea (RR: 0.56, 95% CI: 0.41-0.75, I = 0%, = 0.89) and vomiting (RR: 0.20, 95% CI: 0.05-0.77, I = 0%, = 0.96) and resulted in complete response (RR: 1.61 (1.25-2.08), I = 0%, = 0.70) within the first 2 hours following surgery as well as vomiting in 2-24 hours (RR: 0.09, 95% CI: 0.02-0.36, I = 0%; = 0.81) when compared to placebo or no antiemetic therapy. Preoperative aprepitant 80 mg has a superior overall effect compared to placebo or other antiemetics in the first two hours postoperatively, and thereafter reduces the risk of vomiting alone in the first 24 hours following laparoscopic surgeries.
一项针对MEDLINE、EMBASE和CINAHL数据库的系统性电子检索，旨在比较神经激肽-1受体拮抗剂与其他止吐药在预防接受腹腔镜手术的成年患者术后恶心和呕吐方面的效果，共确定了七项随机对照试验用于综述和荟萃分析。结果发现，术前使用80毫克阿瑞匹坦可减轻恶心（RR：0.56，95%CI：0.41 - 0.75，I² = 0%，P = 0.89）和呕吐（RR：0.20，95%CI：0.05 - 0.77，I² = 0%，P = 0.96），并在术后头两小时内实现完全缓解（RR：1.61（1.25 - 2.08），I² = 0%，P = 0.70），在2至24小时内也可减轻呕吐（RR：0.09，95%CI：0.02 - 0.36，I² = 0%；P = 0.81），与安慰剂或不进行止吐治疗相比。与安慰剂或其他止吐药相比，术前80毫克阿瑞匹坦在术后头两小时具有更好的总体效果，此后在腹腔镜手术后的头24小时内仅降低呕吐风险。
