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Olanzapine as a prophylactic antiemetic for preventing postoperative nausea and vomiting after general anesthesia: A systematic review and meta-analysis.
Grigio, Thiago Ramos; Timmerman, Hans; Sousa, Angela Maria; Wolff, André Paul.
Afiliação
  • Grigio TR; Department of Anaesthesiology, Pain Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Postgraduate Program of Anaesthesiology, Surgical Sciences and Perioperative Medicine, Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP, Brazil
  • Timmerman H; Department of Anaesthesiology, Pain Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  • Sousa AM; Postgraduate Program of Anaesthesiology, Surgical Sciences and Perioperative Medicine, Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP, Brazil.
  • Wolff AP; Department of Anaesthesiology, Pain Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Clinics (Sao Paulo) ; 79: 100345, 2024.
Article em En | MEDLINE | ID: mdl-38513297
ABSTRACT

BACKGROUND:

The antiemetic effectiveness of olanzapine, as a prophylactic off-label antiemetic drug, for Postoperative Nausea and Vomiting (PONV) is unknown. In this systematic review and meta-analysis, the authors evaluate the efficacy and side effects of olanzapine as a prophylactic antiemetic in adult patients who undergo general anesthesia and assess adverse effects.

METHODS:

A systematic search was done on electronic bibliographic databases in July 2023. Randomized controlled trials of olanzapine as a prophylactic antiemetic for PONV in adults who underwent general anesthesia were included. The authors excluded non-RCTs and retracted studies. The authors set no date of publication or language limits. The outcomes were the incidence of PONV within 24 h postoperatively and the safety of olanzapine. The risk of bias was assessed according to the tool suggested by the National Heart, Lung, and Blood Institute.

RESULTS:

Meta-analysis included 446 adult patients. Olanzapine reduced on average 38 % the incidence of PONV. The estimated risk ratio (95 % CI) of olanzapine versus control was 0.62 (0.42-0.90), p = 0.010, I2 = 67 %. In the subgroup meta-analysis, doses of olanzapine (10 mg) reduced on average 49 % of the incidence of PONV (RR = 0.51 [0.34-0.77], p = 0.001, I2 = 31 %).

CONCLUSIONS:

This systematic review with meta-analysis indicated that olanzapine as a prophylactic antiemetic alone or combined with other antiemetic agents reduced the incidence of postoperative nausea and vomiting. However, this conclusion must be presented with some degree of uncertainty due to the small number of studies included. There was a lack of any evidence to draw conclusions on side effects.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Náusea e Vômito Pós-Operatórios / Olanzapina / Anestesia Geral / Antieméticos Limite: Humans Idioma: En Revista: Clinics (Sao Paulo) Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Náusea e Vômito Pós-Operatórios / Olanzapina / Anestesia Geral / Antieméticos Limite: Humans Idioma: En Revista: Clinics (Sao Paulo) Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos