Efficacy and Safety of Tropisetron for Postoperative Nausea and Vomiting: A Meta-analysis of Randomized Controlled Trials_Chinese Journal of Evidence-Based Medicine

Authors：

LI Xiaoqian ,  MA Hong

Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China;

Corresponding author：

MA Hong, Email: mahong5466@yahoo.com

Keywords：

Key words?Tropisetron; Postoperative nausea and vomiting (PONV); 5 HT-3 receptor inhibitor; Meta-analysis

DOI：

10.7507/1672-2531.20100520

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Objective ?To evaluate the efficacy and safety of 5 HT-3 receptor inhibitor tropisetron injected in the postoperative nausea and vomiting (PONV) after general anesthesia.
Methods ?We searched the PubMed, EBSCO, Springer, Ovid, and CNKI to identify randomized controlled trials (RCTs) about tropisetron in preventing PONV after general anesthesia from January 1995 to September 2009. We also consulted references of the included studies for omission. The methodological quality of the included RCTs was assessed and data were extracted according to the standard of the Cochrane Handbook 5.0.1. The meta-analyses were performed by RevMan 4.2.10 software.
Results ?A total of 17 RCTs involving 4 678 patients were included. The results of meta-analyses showed that: (1) Efficacy: tropisetron injected could decrease the incidence of PONV after general anesthesia (RR=0.41, 95%CI 0.29 to 0.60), and decrease the incidence of PONV after general anesthesia with opioid drugs in patient controlled analgesia (RR=0.30, 95%CI 0.15 to 0.60); tropistron injected once or more could decrease the incidence of PONV in combination of PCA with tramadol (RR=0.41, 95%CI 0.29 to 0.56; RR=0.10, 95%CI 0.06 to 0.19); and tropisetron combined with dexamethasome could also lessen the incidence of PONV (RR=0.27, 95%CI 0.13 to 0.57). (2) Safety: Tropisetron injected could lessen the incidence of postoperative headache and dizziness (RR=0.35, 95%CI 0.16 to 0.75), but could not significantly decrease the pruritus and somnolence.
Conclusion ?Tropisetron injected can significantly decrease the incidence of PONV after general anesthesia, and it will not increase the adverse effect and the incidence of postoperative complications. Furthermore, it has also the advantage of decreasing postoperative headache and dizziness.

Citation： LI Xiaoqian,MA Hong. Efficacy and Safety of Tropisetron for Postoperative Nausea and Vomiting: A Meta-analysis of Randomized Controlled Trials. Chinese Journal of Evidence-Based Medicine, 2010, 10(8): 916-922. doi: 10.7507/1672-2531.20100520 Copy

1.	Gan TJ. Selective serotonin 5-HT3 receptor antagonists for postoperative nausea and vomiting: are they all the same? CNS Drugs, 2005, 19(3): 225-238.
2.	朱明炜, 曹金铎, 祝学光, 等. 托烷司琼治疗腹部手术后恶心,呕吐的多中心随机对照研究. 中国药理学杂志, 2003, 9 (12): 96-99.
3.	曹艳, 沈晓凤. 托烷司琼复合地塞米松对妇科腹腔镜术后恶心呕吐的影响. 江苏医药, 2009, 35(1): 62-63.
4.	郭一闽, 王忱. 托烷司琼预防妇科腹腔镜手术后恶心呕吐的效果. 广东医学, 2008, 29(10): 1739-1741.
5.	黄燕虹, 冯丹凤, 张少云, 等. 托烷司琼与格拉司琼预防妇科腹腔镜术后恶心呕吐的比较. 实用诊断与治疗杂志, 2005, 19(12): 870-871.
6.	应永干, 刘礼霞, 郭建荣. 托烷司琼不同时间给药预防术后恶心呕吐的临床观察. 江西医药, 2008, 43(2): 106-107.
7.	徐康清, 王彪, 黄文起, 等. 不同剂量5-HT3受体拮抗剂托烷司琼对全麻术后恶心呕吐的影响的临床研究. 《国外医学》麻醉学与复苏分册, 2005, 26(1): 1-4.
8.	刘艳菊, 杨建新. 地塞米松强化托烷司琼及昂丹司琼抗术后恶心呕吐作用的研究, 临床医药实践杂志, 2007, 16(5): 343-345.
9.	罗怡君, 罗晓敏, 叶庆明, 等. 托烷司琼对全麻术后静脉镇痛恶心呕吐的预防. 现代医院, 2007, 7(3): 42-43.
10.	秦明灿. 盐酸托烷司琼预防术后恶心呕吐的临床观察, 中国实用医药, 2008, 3(13): 155-156.
11.	权翔, 叶铁虎, 朱波. 昂丹司琼、托烷司琼和格拉司琼预防全身麻醉术后恶心呕吐的随机双盲研究. 中国医学科学院学报, 2007, 29( 1): 107-110.
12.	顾漪闻, 应隽, 王祥瑞. 托烷司琼对曲马多静脉自控镇痛相关恶心呕吐的防治作用. 临床麻醉学杂志, 2006, 22(2): 93-95.
13.	柳杰铭, 邬海苏. 不同剂量托烷司琼预防术后患者自控镇痛相关恶心呕吐的效果观察. 中国全科医学, 2009, 12(68): 1103-1104.
14.	陆智杰, 王振猛, 邱海波. 不同给药方式的托烷司琼预防肝脏手术后曲马朵静脉镇痛恶心呕吐的临床观察. 临床军医杂志, 2009, 37(3): 449-451.
15.	Alon E, Kocian R, Nett PC, et al. Tropisetron for the prevention of postoperative nausea and vomiting in women undergoing gynecologic surgery. Anesth Analg, 1996, 82: 338-341.
16.	Alon E, Buchser E, Herrera E, et al. Tropisetron for treating established postoperative nausea and vomiting: a randomized, double-blind, placebo-controlled study. Anesth Analg, 1998, 86: 617-623.
17.	Chan TV, Chui TP, Ho WS, et al. Single-dose tropisetron for preventing postoperative nausea and vomiting after breast surgery. Anesth Analg, 1998, 87: 931-935.
18.	Koivuranta M, Ala-Kokko Ti, Jokelat R, et al. Combined with droperidol for the prevention of emedid in women with a history of post-operative nausea and vomiting. Europ J Anaesth, 1999, 16: 390-395.
19.	Purhonen S, Kauko M, Koski EM, et al. Comparison of tropisetron, droperidol, and saline in the prevention of postoperative nausea and vomiting after gynecologic surgery. Anesth Analg, 1997, 84: 662-667.
20.	Scholz J, Hennes Hj, Steinfath M, et al. Tropisetron or ondansetron compared with placebo for prevention of postoperative nausea and vomiting. Europ J Anaesth, 1998, 15: 676-685.
21.	Capouet V, DePauw CD, Vernet B, et al. Single dose i.v. tropisetronin the prevention of postoperative nausea and vomiting after gynaecological surgery. Br J Anaesth, 1996, 76: 54-60.
22.	Bunce Kj, Tyers MB. The role of 5-HT in postoperative nausea and vomiting. Br J Anaesth, 1992, 69(Suppl 1): 60-62.

1. Gan TJ. Selective serotonin 5-HT3 receptor antagonists for postoperative nausea and vomiting: are they all the same? CNS Drugs, 2005, 19(3): 225-238.
2. 朱明炜, 曹金铎, 祝学光, 等. 托烷司琼治疗腹部手术后恶心,呕吐的多中心随机对照研究. 中国药理学杂志, 2003, 9 (12): 96-99.
3. 曹艳, 沈晓凤. 托烷司琼复合地塞米松对妇科腹腔镜术后恶心呕吐的影响. 江苏医药, 2009, 35(1): 62-63.
4. 郭一闽, 王忱. 托烷司琼预防妇科腹腔镜手术后恶心呕吐的效果. 广东医学, 2008, 29(10): 1739-1741.
5. 黄燕虹, 冯丹凤, 张少云, 等. 托烷司琼与格拉司琼预防妇科腹腔镜术后恶心呕吐的比较. 实用诊断与治疗杂志, 2005, 19(12): 870-871.
6. 应永干, 刘礼霞, 郭建荣. 托烷司琼不同时间给药预防术后恶心呕吐的临床观察. 江西医药, 2008, 43(2): 106-107.
7. 徐康清, 王彪, 黄文起, 等. 不同剂量5-HT3受体拮抗剂托烷司琼对全麻术后恶心呕吐的影响的临床研究. 《国外医学》麻醉学与复苏分册, 2005, 26(1): 1-4.
8. 刘艳菊, 杨建新. 地塞米松强化托烷司琼及昂丹司琼抗术后恶心呕吐作用的研究, 临床医药实践杂志, 2007, 16(5): 343-345.
9. 罗怡君, 罗晓敏, 叶庆明, 等. 托烷司琼对全麻术后静脉镇痛恶心呕吐的预防. 现代医院, 2007, 7(3): 42-43.
10. 秦明灿. 盐酸托烷司琼预防术后恶心呕吐的临床观察, 中国实用医药, 2008, 3(13): 155-156.
11. 权翔, 叶铁虎, 朱波. 昂丹司琼、托烷司琼和格拉司琼预防全身麻醉术后恶心呕吐的随机双盲研究. 中国医学科学院学报, 2007, 29( 1): 107-110.
12. 顾漪闻, 应隽, 王祥瑞. 托烷司琼对曲马多静脉自控镇痛相关恶心呕吐的防治作用. 临床麻醉学杂志, 2006, 22(2): 93-95.
13. 柳杰铭, 邬海苏. 不同剂量托烷司琼预防术后患者自控镇痛相关恶心呕吐的效果观察. 中国全科医学, 2009, 12(68): 1103-1104.
14. 陆智杰, 王振猛, 邱海波. 不同给药方式的托烷司琼预防肝脏手术后曲马朵静脉镇痛恶心呕吐的临床观察. 临床军医杂志, 2009, 37(3): 449-451.
15. Alon E, Kocian R, Nett PC, et al. Tropisetron for the prevention of postoperative nausea and vomiting in women undergoing gynecologic surgery. Anesth Analg, 1996, 82: 338-341.
16. Alon E, Buchser E, Herrera E, et al. Tropisetron for treating established postoperative nausea and vomiting: a randomized, double-blind, placebo-controlled study. Anesth Analg, 1998, 86: 617-623.
17. Chan TV, Chui TP, Ho WS, et al. Single-dose tropisetron for preventing postoperative nausea and vomiting after breast surgery. Anesth Analg, 1998, 87: 931-935.
18. Koivuranta M, Ala-Kokko Ti, Jokelat R, et al. Combined with droperidol for the prevention of emedid in women with a history of post-operative nausea and vomiting. Europ J Anaesth, 1999, 16: 390-395.
19. Purhonen S, Kauko M, Koski EM, et al. Comparison of tropisetron, droperidol, and saline in the prevention of postoperative nausea and vomiting after gynecologic surgery. Anesth Analg, 1997, 84: 662-667.
20. Scholz J, Hennes Hj, Steinfath M, et al. Tropisetron or ondansetron compared with placebo for prevention of postoperative nausea and vomiting. Europ J Anaesth, 1998, 15: 676-685.
21. Capouet V, DePauw CD, Vernet B, et al. Single dose i.v. tropisetronin the prevention of postoperative nausea and vomiting after gynaecological surgery. Br J Anaesth, 1996, 76: 54-60.
22. Bunce Kj, Tyers MB. The role of 5-HT in postoperative nausea and vomiting. Br J Anaesth, 1992, 69(Suppl 1): 60-62.

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Efficacy and Safety of Tropisetron for Postoperative Nausea and Vomiting: A Meta-analysis of Randomized Controlled Trials

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