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Drugs for Postoperative Nausea May Not Help Most Patients

Patients coming out of anesthesia after surgery may experience nausea or vomiting, and are frequently given drugs to prevent this. But the majority of patients won’t benefit from these drugs, according to a large new review of studies.//

The review authors examined 737 studies involving 103,237 patients and found that while nine drugs used as antiemetics can prevent nausea and vomiting, their effectiveness and side effects have not been sufficiently studied.

Not all surgical patients are given drugs for nausea and vomiting, said lead author Dr. John Carlisle, consultant anesthetist at Torbay Hospital in Devon, England. “Anesthetists are more apt to give a drug to patients who they think are more likely to experience postoperative nausea and vomiting or to experience further complications should they vomit.”

Based on the data from the studies reviewed, Carlisle and his colleague concluded that, if 80 of 100 patients were nauseated after surgery and all 100 patients were given antiemetic drugs, 28 would benefit and 72 would not.

The Cochrane Collaboration is an international organization that evaluates medical research. These reviews draw conclusions about medical practice that are based on evidence collected from many clinical studies, after the reviewers consider both the content and quality of medical studies on a given topic.

The drugs found to reliably prevent nausea and vomiting after surgery, according to the review, are cyclizine, droperidol, granisetron, metoclopramide, ondansetron, tropisetron, dolasetron, dexamethasone and ramosetron.

Up to 80 percent of surgical patients may experience nausea or vomiting after their surgery. Nausea and vomiting are obviously uncomfortable and also can delay hospital discharge. Vomiting can stress surgical wounds, cause electrolyte imbalances and cause bleeding.

Side effects of antiemetic drugs given during or just after surgery to prevent na
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