Commonly used antiemetics for prophylaxis of postoperative nausea and vomiting after Caesarean delivery with neuraxial morphine: a network meta-analysis
Authors' conclusion
Combined 5-HT3 antagonists plus dexamethasone are more effective than monotherapy in preventing PONV associated with neuraxial morphine after Caesarean delivery.
Study context
- Population
- Women receiving neuraxial morphine for Caesarean delivery
- Participants
- 4,238 women · 33 studies
- Comparison
- 5-HT3 antagonists, dopamine antagonists, dexamethasone, and 5-HT3 antagonists plus dexamethasone vs placebo
- Outcome
- Incidences of postoperative nausea (PON) and postoperative vomiting (POV)
- Follow-up
- Within 24 h after surgery
Methodological detailsBayesian random-effects model, sensitivity and subgroup analyses, Most included studies had some concerns or a high risk of bias
- Bayesian random-effects model
- Sensitivity and subgroup analyses
- Most included studies had some concerns or a high risk of bias
Pooled result
As reported in the abstract
PON and POV, all women
- 5-HT3 antagonists, dopamine antagonists, dexamethasone, and 5-HT3 antagonists plus dexamethasone significantly reduced postoperative nausea (PON) and postoperative vomiting (POV) vs placebo
- 5-HT3 antagonists plus dexamethasone more effective than monotherapy
- ORs with 95% CrI
- Overall certainty of evidence low or very low
Further pooled results
PON and POV by neuraxial opioid (subgroup)
- Similar results in women receiving epidural morphine or intrathecal morphine alone, but not intrathecal morphine with fentanyl or sufentanil
Original publication
Commonly used antiemetics for prophylaxis of postoperative nausea and vomiting after Caesarean delivery with neuraxial morphine: a network meta-analysis. Br J Anaesth. Published 15 April 2024. doi:10.
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