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Welcome to the Medical Science Review

Medical Science Review (MSR) has developed as an independent title in 2014 as a continuation of highly successful Review Section of the Medical Science Monitor (since 1995). The aim of the Journal is to gather review articles across all medical disciplines, thereby integrating international medical knowledge. Medical Science Review has adopted the Open Access publishing model which enables free access... read more

Published: 2016-05-09

Dexamethasone Prevents Postoperative Nausea and Vomiting After Cesarean Section Under Neuraxial Anesthesia: A Systematic Review and Meta-Analysis

An-liang Li, Hong Gao, Shao-feng Lin, Yan-qiu Liu, Yong-qiang Yin

(Department of Anesthesiology, Guizhou Medical University, Guiyang, Guizhou, China (mainland))

Med Sci Rev 2016; 3:64-72

DOI: 10.12659/MSRev.897540

ABSTRACT: Background:  We performed a meta-analysis to assess the effect of dexamethasone in reducing the occurrence of postoperative nausea or vomiting (PONV) and pruritus in parturient receiving neuraxial anesthesia with neuraxial opioids among cesarean section.
Material abd Methods: We searched PubMed, the Cochrane Central Register of Controlled Trials and EMBASE for all randomized controlled trials to compare dexamethasone with placebo for the prevention of PONV in parturients under a neuraxial anesthetic methods. Data were extracted independently by the authors. The incidence of PONV and pruritus in 24 hours, use of rescue anti-emetics, early pain scores at or around 4 hours and postoperative pain scores at 24 hours were statistics. Using the Review Manager (Review Manager version 5.3 (Cochrane Collaboration, Oxford, UK) complete meta-analysis and calculating the Odds ratio(OR) and 95% confidence interval (CI).
Results: Finally, seven randomized controlled trails were included in the study. From these trials, total 484 patients were analyzed with 241 receiving dexamethasone and 243 receiving placebo. At 24 hours after surgery, compared with placebo, dexamethasone reduced the incidence of postoperative nausea (OR [95% CI]=0.42 [0.26, 0.67]), postoperative vomiting (OR [95% CI]=0.38[0.24,0.62]) and the use of rescue antiemetic (OR [95% CI]=0.21 [0.10, 0.44]). Dexamethasone also reduced early pain scores at or around 4 hours (MD [95% CI]=–0.85[–1.59, –0.10]) and 24-hour visual analog pain scores (MD [95% CI]=–0.89(–1.35, –0.43)]. However, dexamethasone cannot reduce the incidence of pruritus (OR [95% CI]=0.86 [0.54, 1.38]).
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Keywords: Anesthesia, Spinal, Cesarean Section, Dexamethasone, Postoperative Nausea and Vomiting

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