• Hepato Gastroenterol · Oct 2012

    Review Meta Analysis

    Efficacy of ondansetron vs. metoclopramide in prophylaxis of postoperative nausea and vomiting after laparoscopic cholecystectomy: a systematic review and meta-analysis.

    • Si-Jia Wu, Xian-Ze Xiong, Tie-Yao Cheng, Yi-Xin Lin, and Nan-Sheng Cheng.
    • Department of Bile Duct Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
    • Hepato Gastroenterol. 2012 Oct 1;59(119):2064-74.

    Background/AimsThe incidence of postoperative nausea and vomiting is truly high after laparoscopic cholecystectomy. Ondansetron and metoclopramide may be effective in preventing it. Our aim was to estimate the efficacy of ondansetron vs. metoclopramide in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy.MethodologyWe searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Science Citation Index Expanded, EMBASE etc. to obtain relevant randomized controlled trials until October 2011. Two authors independently assessed the trials for inclusion and extracted the data. The odds ratio (OR) for dichotomous data was used with 95% confidence intervals (CI). Sensitivity and subgroup analysis were performed, if necessary.ResultsThe total incidence of postoperative nausea and vomiting within 24 hours after laparoscopic cholecystectomy was 31% (74 of 235) in the ondansetron group and 56% (127 of 225) in the metoclopramide group (OR=0.33, 95%CI=0.22-0.49, p<0.00001, 12=49%). The total incidences of nausea and vomiting were lower in the ondansetron group (OR=0.28, 95%CI=0.15-0.54, p=0.0002, I²=0%) and (OR=0.31, 95%CI=0.17-0.55, p<0.0001, I²=0%), respectively.ConclusionsBased on the evidence, ondansetron has a better effect than metoclopramide for preventing postoperative nausea and vomiting after laparoscopic cholecystectomy. If we ignore the price factor, ondansetron is recommended for adhibition.

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