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

Autor: Pankiv E; Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada., Albornoz AE; Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada., Nghiem J; Department of Anaesthesia, The Children's Hospital at Westmead, Westmead, NSW, Australia., Petre MA; Department of Anesthesia, Montreal Children's Hospital, Montreal, QC, Canada., Englesakis M; Library and Information Services, University Health Network, Toronto, ON, Canada., Rana M; Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada., Mc Donnell C; Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada., Hayes J; Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada., Aoyama K; Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada. kazu.aoyama@utoronto.ca.; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada. kazu.aoyama@utoronto.ca.; Department of Anesthesiology and Pain Medicine, University of Toronto, #2211-555 University Ave, Toronto, ON, M5G 1X8, Canada. kazu.aoyama@utoronto.ca.
Jazyk: angličtina
Zdroj: Canadian journal of anaesthesia = Journal canadien d'anesthesie [Can J Anaesth] 2023 Dec; Vol. 70 (12), pp. 1978-1988. Date of Electronic Publication: 2023 Oct 05.
DOI: 10.1007/s12630-023-02560-w
Abstrakt: 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.
(© 2023. The Author(s).)
Databáze: MEDLINE
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