Comparison between ondansetron and granisetron in preventing nausea and vomiting after laparoscopic cholecystectomy: A systematic review and meta-analysis.
Waleed D Khubzan, Mohammed H Albagieh, Ruyuf A Nathif, Waad M Alshamrani, Nawaf S Alharbi, Reem A Sharahili, Naif M Alsaeed, Mohammedeid M Mahfouz
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引用次数: 0
Abstract
Objectives: To find the most optimal drug for post-operative nausea and vomiting (PONV) prophylaxis after laparoscopic cholecystectomy (LC) by comparing ondansetron and granisetron.
Methods: We carried out our study in adherence to the Preferred Reporting Items for Systematic reviews and Meta-Analyses instructions. Google Scholar, PubMed, Web of Science, and Ovid MEDLINE (through November 2024) were searched for studies comparing ondansetron and granisetron after LC. Primary outcomes include the incidence of PONV at 0-12 hour and 0-24 hour time points; secondary outcomes included rescue anti-emetic use and adverse effects. All data analysis and the quality assessment were carried out by utilizing review manager 5.4.
Results: A total of 21 studies encompassing 1539 patients were included; 17 of them were eligible for meta-analysis. Compared with ondansetron, granisetron was effective in reducing nausea (15.2% vs. 25.4%; risk ratio [RR]=1.67, I2=7%, p=0.0001) and vomiting (10.3% vs. 18%; RR=1.73, I2=49%, p=0.001) within the first 12 hours. At 24-hour time point, granisetron was once again superior in reducing the episodes of nausea (21.8% vs. 38.5%, I2=35%) and vomiting (13.4% vs. 23.3%, I2=52%), with low-to-moderate heterogeneity. Patients on granisetron required less rescue anti-emetics (10.7% vs. 23.1%; RR=2.14, I2=32%, p<0.0001). Adverse effects were also fewer with granisetron (p=0.04).
Conclusion: According to our findings, granisetron was superior in preventing PONV when compared to ondansetron following LC, with fewer rescue anti-emetics and adverse effects. Further research on cost-effectiveness and optimal dosing is required.PROSPERO No. ID: CRD42024623780.
目的：通过对昂丹司琼与格拉司琼的比较，寻找预防腹腔镜胆囊切除术后恶心呕吐（PONV）的最佳药物。方法：我们按照系统评价和荟萃分析指导的首选报告项目进行了研究。b谷歌Scholar， PubMed， Web of Science和Ovid MEDLINE（截至2024年11月）检索了LC后比较昂丹司琼和格拉司琼的研究。主要结局包括0-12小时和0-24小时时间点PONV的发生率；次要结局包括抢救止吐药的使用和不良反应。所有数据分析和质量评价均采用review manager 5.4进行。结果：共纳入21项研究，共1539例患者；其中17例符合meta分析。与昂丹司琼相比，格拉司琼能有效减轻恶心(15.2% vs 25.4%；危险比[RR]=1.67, I2=7%, p=0.0001)和呕吐(10.3% vs. 18%；RR=1.73, I2=49%, p=0.001)。在24小时时间点，格拉司琼在减少恶心（21.8% vs. 38.5%, I2=35%）和呕吐（13.4% vs. 23.3%, I2=52%）发作方面再次具有优势，异质性低至中等。格拉司琼组患者需要较少的抢救性止吐剂(10.7% vs. 23.1%；RR=2.14, I2=32%, pp=0.04)。结论：根据我们的研究结果，格拉司琼在LC后预防PONV的效果优于昂丹司琼，且救助性止吐剂和不良反应较少。需要进一步研究成本效益和最佳剂量。普洛斯彼罗。ID: CRD42024623780。
期刊介绍：
The Saudi Medical Journal is a monthly peer-reviewed medical journal. It is an open access journal, with content released under a Creative Commons attribution-noncommercial license.
The journal publishes original research articles, review articles, Systematic Reviews, Case Reports, Brief Communication, Brief Report, Clinical Note, Clinical Image, Editorials, Book Reviews, Correspondence, and Student Corner.
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