A factorial trial of six interventions for the prevention of postoperative nausea and vomiting

Basit Öğe Kaydı
dc.authoridSneyd, John/0000-0003-3546-9856
dc.authoridSneyd, John Robert/0000-0003-3546-9856
dc.authoridSneyd, John/0000-0003-3546-9856
dc.authoridSessler, Daniel Ira/0000-0001-9932-3077
dc.authoridKredel, Markus/0000-0003-2183-033X
dc.authorwosidSneyd, John/AFV-7887-2022
dc.authorwosidSneyd, John Robert/B-2957-2012
dc.authorwosidSneyd, John/AFV-7886-2022
dc.authorwosidSessler, Daniel Ira/D-3504-2011
dc.authorwosidJokela, Ritva/E-1286-2013
dc.contributor.authorApfel, CC
dc.contributor.authorKorttila, K
dc.contributor.authorAbdalla, M
dc.contributor.authorKerger, H
dc.contributor.authorTuran, A
dc.contributor.authorVedder, I
dc.contributor.authorZernak, C
dc.date.accessioned2024-06-12T11:20:01Z
dc.date.available2024-06-12T11:20:01Z
dc.date.issued2004
dc.departmentTrakya Üniversitesien_US
dc.descriptionAnnual Meeting of the American-Society-of-Anesthesiologists -- OCT 11-15, 2003 -- SAN FRANCISCO, CAen_US
dc.description.abstractBACKGROUND Untreated, one third of patients who undergo surgery will have postoperative nausea and vomiting. Although many trials have been conducted, the relative benefits of prophylactic antiemetic interventions given alone or in combination remain unknown. METHODS We enrolled 5199 patients at high risk for postoperative nausea and vomiting in a randomized, controlled trial of factorial design that was powered to evaluate interactions among as many as three antiemetic interventions. Of these patients, 4123 were randomly assigned to 1 of 64 possible combinations of six prophylactic interventions: 4 mg of ondansetron or no ondansetron; 4 mg of dexamethasone or no dexamethasone; 1.25 mg of droperidol or no droperidol; propofol or a volatile anesthetic; nitrogen or nitrous oxide; and remifentanil or fentanyl. The remaining patients were randomly assigned with respect to the first four interventions. The primary outcome was nausea and vomiting within 24 hours after surgery, which was evaluated blindly. Results Ondansetron, dexamethasone, and droperidol each reduced the risk of postoperative nausea and vomiting by about 26 percent. Propofol reduced the risk by 19 percent, and nitrogen by 12 percent; the risk reduction with both of these agents ( i.e., total intravenous anesthesia) was thus similar to that observed with each of the antiemetics. All the interventions acted independently of one another and independently of the patients' baseline risk. Consequently, the relative risks associated with the combined interventions could be estimated by multiplying the relative risks associated with each intervention. Absolute risk reduction, though, was a critical function of patients' baseline risk. CONCLUSIONS Because antiemetic interventions are similarly effective and act independently, the safest or least expensive should be used first. Prophylaxis is rarely warranted in low-risk patients, moderate-risk patients may benefit from a single intervention, and multiple interventions should be reserved for high-risk patients.en_US
dc.description.sponsorshipAmer Soc Anesthesiologistsen_US
dc.description.sponsorshipNIGMS NIH HHS [R01 GM061655-03, R01 GM061655, GM 061655] Funding Source: Medlineen_US
dc.identifier.doi10.1056/NEJMoa032196
dc.identifier.endpage2451en_US
dc.identifier.issn0028-4793
dc.identifier.issn1533-4406
dc.identifier.issue24en_US
dc.identifier.pmid15190136en_US
dc.identifier.scopus2-s2.0-2942532387en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage2441en_US
dc.identifier.urihttps://doi.org/10.1056/NEJMoa032196
dc.identifier.urihttps://hdl.handle.net/20.500.14551/25437
dc.identifier.volume350en_US
dc.identifier.wosWOS:000221887200003en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherMassachusetts Medical Socen_US
dc.relation.ispartofNew England Journal Of Medicineen_US
dc.relation.publicationcategoryKonferans Öğesi - Uluslararası - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectSupplemental Oxygenen_US
dc.subjectCost-Effectivenessen_US
dc.subjectOndansetronen_US
dc.subjectDroperidolen_US
dc.subjectEfficacyen_US
dc.subjectDexamethasoneen_US
dc.subjectAnesthesiaen_US
dc.subjectManagementen_US
dc.subjectEmphysemaen_US
dc.subjectReduceen_US
dc.titleA factorial trial of six interventions for the prevention of postoperative nausea and vomitingen_US
dc.typeConference Objecten_US

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayınlar Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu