Why the study?
Very few prospective trials have evaluated rescue treatment for postoperative nausea and vomiting after prophylaxis failure, leaving uncertainty regarding optimal dosing, onset, duration, safety, and efficacy.
What is the efficacy and safety of rescue antiemetics in surgical patients with postoperative nausea and vomiting after failure of prophylaxis?
What is the efficacy and safety of rescue antiemetics in surgical patients with postoperative nausea and vomiting after failure of prophylaxis?
This systematic review aims to summarize the current evidence on rescue treatments for postoperative nausea and vomiting after prophylaxis failure to optimize postoperative recovery.
May support avoiding same-class rescue antiemetics after prophylaxis failure; leaves open optimal regimens for randomized trials.
Although prophylactic antiemetics are commonly used perioperatively, an estimated 30% of surgical patients still suffer from postoperative nausea and vomiting (PONV). Very few prospective trials have studied rescue treatment of PONV after failure of prophylaxis, providing limited evidence to support clinical management. In patients who have failed PONV prophylaxis, administering a rescue antiemetic from the same drug class has been reported to be ineffective. For many antiemetics currently used in PONV rescue, significant uncertainty remains around the effective dose range, speed of onset, duration of effect, safety, and overall risk-benefit ratio. As prompt, effective PONV rescue after failure of prophylaxis is important to optimize postoperative recovery and resource utilization, we conduct this systematic review to summarize the current evidence available on the topic.
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Gan et al. (2022) studied this question.
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