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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

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Open Access 05-10-2023 | Postoperative Nausea and Vomiting | Review Article/Brief Review

Prophylaxis for pediatric postoperative nausea and vomiting: a scoping review of clinical trials

Authors: Evelina Pankiv, MD, FRCPC, Alfonso E. Albornoz, MD, Jessica Nghiem, MBBS, FANZCA, Maria-Alexandra Petre, MD, FRCPC, Marina Englesakis, MLIS, Mehwish Rana, HBSc, Conor Mc Donnell, MB, MD, FFARCSI, Jason Hayes, MD, FRCPC, Kazuyoshi Aoyama, MD, PhD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 12/2023

Abstract

Purpose

Postoperative nausea and vomiting (PONV) is common in pediatric patients undergoing general anesthesia, and clinicians seek prophylactic interventions to prevent its ill effects on patients as well as its ramifications on perioperative care. We sought to assess the body of evidence around prophylactic strategies, both pharmacologic and nonpharmacologic, targeting pediatric PONV.

Source

We searched MEDLINE, MEDLINE ePubs Ahead of Print and In-Process Citations, Embase Classic+Embase, the Cochrane Database of Systematic Reviews, Cochrane CENTRAL (via the Ovid platform), Scopus (Elsevier), Web of Science (Clarivate Analytics), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and the International Standard Randomized Controlled Trial Number Registry, from their inception to 23 September 2022.

Principal findings

Of 188 clinical trials, 157 (83%) investigated pharmacologic interventions, 25 (13%) investigated nonpharmacologic interventions, and six (3%) investigated mixed pharmacologic and nonpharmacologic interventions. The most common surgeries investigated for pediatric PONV were strabismus surgery (68 trials, 36%) and tonsillectomy or tympanoplasty (45 trials, 23%). Of four measurement tools used to assess PONV in the included trials, the most common was clinical judgement (170 trials, 90%).

Conclusion

The majority of data in pediatric PONV prophylaxis is based on pharmacologic interventions, with a paucity of research in nonpharmacologic or mixed interventions. Assessing and documenting PONV using tools such as the Baxter Animated Retching Faces Scale or PONV numeric scoring system may help standardize pediatric PONV prophylaxis research moving forward. Furthermore, concurrently assessing pain and adverse effects associated with PONV might further inform our understanding of this complex clinical entity.

Available only for authorised users

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Title: Prophylaxis for pediatric postoperative nausea and vomiting: a scoping review of clinical trials
Authors: Evelina Pankiv, MD, FRCPC
Alfonso E. Albornoz, MD
Jessica Nghiem, MBBS, FANZCA
Maria-Alexandra Petre, MD, FRCPC
Marina Englesakis, MLIS
Mehwish Rana, HBSc
Conor Mc Donnell, MB, MD, FFARCSI
Jason Hayes, MD, FRCPC
Kazuyoshi Aoyama, MD, PhD
Publication date: 05-10-2023
Publisher: Springer International Publishing
Keywords: Postoperative Nausea and Vomiting
General Anesthesia
Tonsillectomy
Tympanoplasty
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 12/2023
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-023-02560-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prophylaxis for pediatric postoperative nausea and vomiting: a scoping review of clinical trials

Abstract

Purpose

Source

Principal findings

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Source

Principal findings

Conclusion

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