-
The Cochrane Database of Systematic... Jul 2020Maternal hypotension is the most frequent complication of spinal anaesthesia for caesarean section. It can be associated with nausea or vomiting and may pose serious... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Maternal hypotension is the most frequent complication of spinal anaesthesia for caesarean section. It can be associated with nausea or vomiting and may pose serious risks to the mother (unconsciousness, pulmonary aspiration) and baby (hypoxia, acidosis, neurological injury).
OBJECTIVES
To assess the effects of prophylactic interventions for hypotension following spinal anaesthesia for caesarean section.
SEARCH METHODS
We searched Cochrane Pregnancy and Childbirth's Trials Register (9 August 2016) and reference lists of retrieved studies.
SELECTION CRITERIA
Randomised controlled trials, including full texts and abstracts, comparing interventions to prevent hypotension with placebo or alternative treatment in women having spinal anaesthesia for caesarean section. We excluded studies if hypotension was not an outcome measure.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed study quality and extracted data from eligible studies. We report 'Summary of findings' tables using GRADE.
MAIN RESULTS
We included 125 studies involving 9469 women. Interventions were to prevent maternal hypotension following spinal anaesthesia only, and we excluded any interventions considered active treatment. All the included studies reported the review's primary outcome. Across 49 comparisons, we identified three intervention groups: intravenous fluids, pharmacological interventions, and physical interventions. Authors reported no serious adverse effects with any of the interventions investigated. Most trials reported hypotension requiring intervention and Apgar score of less than 8 at five minutes as the only outcomes. None of the trials included in the comparisons we describe reported admission to neonatal intensive care unit. Crystalloid versus control (no fluids) Fewer women experienced hypotension in the crystalloid group compared with no fluids (average risk ratio (RR) 0.84, 95% confidence interval (CI) 0.72 to 0.98; 370 women; 5 studies; low-quality evidence). There was no clear difference between groups in numbers of women with nausea and vomiting (average RR 0.19, 95% CI 0.01 to 3.91; 1 study; 69 women; very low-quality evidence). No baby had an Apgar score of less than 8 at five minutes in either group (60 babies, low-quality evidence). Colloid versus crystalloid Fewer women experienced hypotension in the colloid group compared with the crystalloid group (average RR 0.69, 95% CI 0.58 to 0.81; 2009 women; 27 studies; very low-quality evidence). There were no clear differences between groups for maternal hypertension requiring intervention (average RR 0.64, 95% CI 0.09 to 4.46, 3 studies, 327 women; very low-quality evidence), maternal bradycardia requiring intervention (average RR 0.98, 95% CI 0.54 to 1.78, 5 studies, 413 women; very low-quality evidence), nausea and/or vomiting (average RR 0.89, 95% CI 0.66 to 1.19, 14 studies, 1058 women, I² = 29%; very low-quality evidence), neonatal acidosis (average RR 0.83, 95% CI 0.15 to 4.52, 6 studies, 678 babies; very low-quality evidence), or Apgar score of less than 8 at five minutes (average RR 0.24, 95% CI 0.03 to 2.05, 10 studies, 730 babies; very low-quality evidence). Ephedrine versus phenylephrine There were no clear differences between ephedrine and phenylephrine groups for preventing maternal hypotension (average RR 0.92, 95% CI 0.71 to 1.18; 401 women; 8 studies; very low-quality evidence) or hypertension (average RR 1.72, 95% CI 0.71 to 4.16, 2 studies, 118 women, low-quality evidence). Rates of bradycardia were lower in the ephedrine group (average RR 0.37, 95% CI 0.21 to 0.64, 5 studies, 304 women, low-quality evidence). There was no clear difference in the number of women with nausea and/or vomiting (average RR 0.76, 95% CI 0.39 to 1.49, 4 studies, 204 women, I² = 37%, very low-quality evidence), or babies with neonatal acidosis (average RR 0.89, 95% CI 0.07 to 12.00, 3 studies, 175 babies, low-quality evidence). No baby had an Apgar score of less than 8 at five minutes in either group (321 babies; low-quality evidence). Ondansetron versus control Ondansetron administration was more effective than control (placebo saline) for preventing hypotension requiring treatment (average RR 0.67, 95% CI 0.54 to 0.83; 740 women, 8 studies, low-quality evidence), bradycardia requiring treatment (average RR 0.49, 95% CI 0.28 to 0.87; 740 women, 8 studies, low-quality evidence), and nausea and/or vomiting (average RR 0.35, 95% CI 0.24 to 0.51; 653 women, 7 studies, low-quality evidence). There was no clear difference between the groups in rates of neonatal acidosis (average RR 0.48, 95% CI 0.05 to 5.09; 134 babies; 2 studies, low-quality evidence) or Apgar scores of less than 8 at five minutes (284 babies, low-quality evidence). Lower limb compression versus control Lower limb compression was more effective than control for preventing hypotension (average RR 0.61, 95% CI 0.47 to 0.78, 11 studies, 705 women, I² = 65%, very low-quality evidence). There was no clear difference between the groups in rates of bradycardia (RR 0.63, 95% CI 0.11 to 3.56, 1 study, 74 women, very low-quality evidence) or nausea and/or vomiting (average RR 0.42, 95% CI 0.14 to 1.27, 4 studies, 276 women, I² = 32%, very-low quality evidence). No baby had an Apgar score of less than 8 at five minutes in either group (130 babies, very low-quality evidence). Walking versus lying There was no clear difference between the groups for women with hypotension requiring treatment (RR 0.71, 95% CI 0.41 to 1.21, 1 study, 37 women, very low-quality evidence). Many included studies reported little to no information that would allow an assessment of their risk of bias, limiting our ability to draw meaningful conclusions. GRADE assessments of the quality of evidence ranged from very low to low. We downgraded evidence for limitations in study design, imprecision, and indirectness; most studies assessed only women scheduled for elective caesarean sections. External validity also needs consideration. Readers should question the use of colloids in this context given the serious potential side effects such as allergy and renal failure associated with their administration.
AUTHORS' CONCLUSIONS
While interventions such as crystalloids, colloids, ephedrine, phenylephrine, ondansetron, or lower leg compression can reduce the incidence of hypotension, none have been shown to eliminate the need to treat maternal hypotension in some women. We cannot draw any conclusions regarding rare adverse effects associated with use of the interventions (for example colloids) due to the relatively small numbers of women studied.
Topics: Anesthesia, Obstetrical; Anesthesia, Spinal; Antiemetics; Cesarean Section; Colloids; Crystalloid Solutions; Ephedrine; Female; Humans; Hypotension; Intraoperative Complications; Isotonic Solutions; Ondansetron; Phenylephrine; Postoperative Nausea and Vomiting; Pregnancy; Randomized Controlled Trials as Topic; Vasoconstrictor Agents; Walking
PubMed: 32619039
DOI: 10.1002/14651858.CD002251.pub4 -
Cancer Medicine Jun 2023To assess the effectiveness and safety of acupuncture for the prevention of chemotherapy-induced nausea and vomiting (CINV), with a specific intention on exploring... (Meta-Analysis)
Meta-Analysis
PURPOSE
To assess the effectiveness and safety of acupuncture for the prevention of chemotherapy-induced nausea and vomiting (CINV), with a specific intention on exploring sources of between-study variation in treatment effects.
METHODS
MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Periodicals Database, China National Knowledge Infrastructure, and Wanfang were searched to identify randomized controlled trials (RCTs) that compared acupuncture to sham acupuncture or usual care (UC). The main outcome is complete control (no vomiting episodes and/or no more than mild nausea) of CINV. GRADE approach was used to rate the certainty of evidence.
RESULTS
Thirty-eight RCTs with a total of 2503 patients were evaluated. Acupuncture in addition to UC may increase the complete control of acute vomiting (RR, 1.13; 95% CI, 1.02 to 1.25; 10 studies) and delayed vomiting (RR, 1.47; 95% CI, 1.07 to 2.00; 10 studies) when compared with UC only. No effects were found for all other review outcomes. The certainty of evidence was generally low or very low. None of the predefined moderators changed the overall findings, but in an exploratory moderator analysis we found that an adequate reporting of planned rescue antiemetics might decrease the effect size of complete control of acute vomiting (p = 0.035).
CONCLUSION
Acupuncture in addition to usual care may increase the complete control of chemotherapy-induced acute vomiting and delayed vomiting but the certainty of evidence was very low. Well-designed RCTs with larger sample sizes, standardized treatment regimens, and core outcome measures are needed.
Topics: Humans; Antineoplastic Agents; Vomiting; Nausea; Antiemetics; Neoplasms; Acupuncture Therapy
PubMed: 37226372
DOI: 10.1002/cam4.5962 -
The American Journal of Chinese Medicine 2017Postoperative ileus is a common and often life-threatening gastrointestinal complication with few management methods available for patients. Integrating acupressure into... (Meta-Analysis)
Meta-Analysis Review
Postoperative ileus is a common and often life-threatening gastrointestinal complication with few management methods available for patients. Integrating acupressure into perioperative care promises to bring benefits into preventing postoperative ileus. This systematic review and meta-analysis aims to evaluate the efficacy of acupressure in identifying the signs and symptoms of postoperative ileus among patients undergoing abdominal surgery. The MEDLINE, EMBASE, Web of Science, CINAHL, China Journal Net and Wanfang databases were searched for high-quality RCTs using keywords such as acupressure, postoperative ileus, abdominal surgery, etc. A total of six studies ([Formula: see text]) were included in this review and meta-analysis. The quality of the literature was found to be uniformly moderate by the Effective Public Health Practice Project (EPHPP) assessment tool. The results of meta-analyses revealed that acupressure could significantly reduce risks for postoperative nausea (OR 0.52, 95% CI 0.39-0.70, [Formula: see text]) and vomiting (OR 0.54, 95% CI 0.39-0.75, [Formula: see text]) compared with the control group, without significant heterogeneity among studies. Meta-analysis of the need for antiemetic drugs suggested that the OR was 0.39 (95% CI 0.20-0.78, [Formula: see text]) with significant heterogeneity among studies. Our results suggested that acupressure might be effective in reducing the incidence of postoperative nausea and vomiting and the need for antiemetic drugs among patients undergoing abdominal surgery. Considering the substantial risk of bias in the articles included, future high-quality RCTs with a rigorous methodology are desirable to provide solid evidence. Furthermore, other signs and symptoms of postoperative ileus should be explored in future.
Topics: Abdomen; Acupressure; Databases, Bibliographic; Humans; Ileus; Postoperative Complications; Postoperative Nausea and Vomiting; Randomized Controlled Trials as Topic
PubMed: 28830215
DOI: 10.1142/S0192415X17500616 -
Cancer Chemotherapy and Pharmacology Jul 2022Ifosfamide is one of the chemotherapy regimens which potentially causes neurotoxicity in patients up to 30%. Aprepitant is administered as an anti-emetic agent in... (Review)
Review
Ifosfamide is one of the chemotherapy regimens which potentially causes neurotoxicity in patients up to 30%. Aprepitant is administered as an anti-emetic agent in chemotherapy and regarding the inhibitory effect on CYP3A4, aprepitant can increase the risk of ifosfamide adverse effects. This study aims to systematically investigate the relation of ifosfamide-induced neurotoxicity and aprepitant or fosaprepitant in chemotherapy cancer patients. Four databases including PubMed, Scopus, Web of Science, and Embase were systematically reviewed without language restriction and hand searching was performed until December 2021. Total 1639 publications were retrieved and nine studies fulfilled the eligibility criteria. For quality assessment, we used Newcastle-Ottawa quality assessment scales (NOS) for retrospective cohort studies and Cochrane Collaboration tool to assess the risk of bias for a randomized controlled trial. Overall, the results of our systematic review indicated a positive enhanced trend between neurotoxicity and concomitant use of ifosfamide and aprepitant or fosaprepitant, but the association was not statistically significant. As indicated by our findings, several studies identified low albumin as a risk factor for ifosfamide-induced encephalopathy. However, further clinical studies with a larger population of patients are required to evaluate the clinical significance of ifosfamide-related neurotoxicity and aprepitant or fosaprepitant.
Topics: Aprepitant; Humans; Ifosfamide; Morpholines; Neurotoxicity Syndromes; Randomized Controlled Trials as Topic; Retrospective Studies
PubMed: 35635561
DOI: 10.1007/s00280-022-04439-x -
Drug Safety Jun 2016Prochlorperazine is recommended for adults with breakthrough or refractory chemotherapy-induced nausea and vomiting (CINV). The objective of this review was to describe... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Prochlorperazine is recommended for adults with breakthrough or refractory chemotherapy-induced nausea and vomiting (CINV). The objective of this review was to describe its safety in children when given for any indication to help define its role for CINV control in children.
METHODS
Electronic searches of MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials were performed as of 9 March 2015. All studies in English reporting adverse effects (AEs) associated with prochlorperazine in children (≤18 years) were included. AEs were synthesized for prospective studies.
RESULTS
Forty-nine (15 prospective) studies evaluating the use of prochlorperazine in 758 children were included. The most commonly reported AEs in prospective studies of prochlorperazine in children were sedation (multiple-dose studies: 10 %, 95 % CI 5-21) and extrapyramidal symptoms (EPS) (single-dose studies: 9 %, 95 % CI 3-29; multiple-dose studies: 4 %, 95 % CI 1-11). Serious AEs (seizure, neuroleptic malignant syndrome, autonomic collapse, tardive dyskinesia) were rarely associated with prochlorperazine use in children. Five fatalities were reported in children receiving prochlorperazine.
LIMITATIONS
The limitations of this systematic review and meta-analysis were that the AEs reported in the included studies were heterogeneous, the prospective use of systematic clinical tools to identify AEs was rare, and the risk of bias in most prospective studies was moderate.
CONCLUSIONS
The most common AEs reported with the pediatric use of prochlorperazine are EPS and sedation. Fatalities, life-threatening, and persistent AEs have also been reported.
Topics: Antiemetics; Antineoplastic Agents; Chemotherapy-Induced Febrile Neutropenia; Child; Child Health Services; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Male; Nausea; Prochlorperazine; Risk Assessment; Vomiting
PubMed: 26884326
DOI: 10.1007/s40264-016-0398-9 -
Evidence-based Complementary and... 2017Nausea and vomiting are distressing symptoms for patients receiving chemotherapy. Moxibustion, which involves the use of burning moxa to generate heat and stimulate... (Review)
Review
Nausea and vomiting are distressing symptoms for patients receiving chemotherapy. Moxibustion, which involves the use of burning moxa to generate heat and stimulate acupoints, has been reported to potentially ameliorate chemotherapy-induced side effects, particularly nausea and vomiting. This systematic review evaluated current evidence on the effectiveness of moxibustion against chemotherapy-induced nausea and vomiting (CINV). We searched eight online databases and two trial registries for relevant trials. The random-effects model was used to conduct a meta-analysis. Furthermore, the risk ratio (RR) and mean difference (MD) were used to explain dichotomous and continuous outcomes, respectively; the outcomes were within 95% confidence intervals (CIs). The results revealed that moxibustion might more favorably relieve the severity and frequency of CINV, compared with no treatment (RR: 2.04, 95% CI: 1.42-2.93); moxibustion might have stronger effects than antiemetic drugs (RR: 1.87, 95% CI: 1.27-2.76). There is no robust result that moxibustion could enhance the effects of antiemetic drugs administered as a complementary treatment. Actual moxibustion (8.10 ± 10.98) may have more favorable effects than placebo moxibustion (46.67 ± 23.32). However, the evidence obtained is not sufficient because of the lack of strict clinical trials. . This trial is registered with PROSPERO CRD42016030037.
PubMed: 29234451
DOI: 10.1155/2017/9854893 -
PloS One 2015Gastroenteritis remains a leading cause of childhood morbidity. (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Gastroenteritis remains a leading cause of childhood morbidity.
OBJECTIVE
Because prior reviews have focused on isolated symptoms and studies conducted in developing countries, this study focused on interventions commonly considered for use in developed countries. Intervention specific, patient-centered outcomes were selected.
DATA SOURCES
MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, trial registries, grey literature, and scientific meetings.
STUDY SELECTION
Randomized controlled trials, conducted in developed countries, of children aged <18 years, with gastroenteritis, performed in emergency department or outpatient settings which evaluated oral rehydration therapy (ORT), antiemetics, probiotics or intravenous fluid administration rate.
DATA EXTRACTION
The study was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. Data were independently extracted by multiple investigators. Analyses employed random effects models.
RESULTS
31 trials (4,444 patients) were included. ORT: Compared with intravenous rehydration, hospitalization (RR 0.80, 95%CI 0.24, 2.71) and emergency department return visits (RR 0.86, 95%CI 0.39, 1.89) were similar. Antiemetics: Fewer children administered an antiemetic required intravenous rehydration (RR 0.40, 95%CI 0.26, 0.60) While the data could not be meta-analyzed, three studies reported that ondansetron administration does increase the frequency of diarrhea. Probiotics: No studies reported on the primary outcome, three studies evaluated hospitalization within 7 days (RR 0.87, 95%CI 0.25, 2.98). Rehydration: No difference in length of stay was identified for rapid vs. standard intravenous or nasogastric rehydration. A single study found that 5% dextrose in normal saline reduced hospitalizations compared with normal saline alone (RR 0.70, 95% CI 0.53, 0.92).
CONCLUSIONS
There is a paucity of patient-centered outcome evidence to support many interventions. Since ORT is a low-cost, non-invasive intervention, it should continue to be used. Routine probiotic use cannot be endorsed at this time in outpatient children with gastroenteritis. Despite some evidence that ondansetron administration increases diarrhea frequency, emergency department use leads to reductions in intravenous rehydration and hospitalization. No benefits were associated with ondansetron use following emergency department discharge.
Topics: Adolescent; Age Factors; Antiemetics; Child; Child, Preschool; Combined Modality Therapy; Developed Countries; Fluid Therapy; Gastroenteritis; Humans; Infant; Morbidity; Odds Ratio; Outcome Assessment, Health Care; Probiotics; Randomized Controlled Trials as Topic
PubMed: 26075617
DOI: 10.1371/journal.pone.0128754 -
Supportive Care in Cancer : Official... Jun 2023Cancer treatment-related nausea and vomiting continue to be common and distressing symptoms for patients, despite improvements in antiemetics. Dietary modifications... (Review)
Review
BACKGROUND
Cancer treatment-related nausea and vomiting continue to be common and distressing symptoms for patients, despite improvements in antiemetics. Dietary modifications could potentially improve this symptom experience. Clinicians frequently provide dietary advice to patients, although the evidence base of such suggestions or recommendations is not clear.
PURPOSE
This systematic review aimed to examine the current literature on food interventions associated with improvements in cancer treatment-related nausea and vomiting.
METHODS
Eight electronic databases were searched with a specific search term strategy covering trials without time or language limitations. Eligible studies focused on a food substance, defined as any nutritious substance that people eat or drink to maintain life and well-being. Trials in children and adults during chemotherapy or radiotherapy were included. Cochrane risk of bias tool was used to assess trial quality and GRADE was used to assess the certainty in the effect of each outcome.
RESULTS
Seventeen trials were included, 3 focusing on children and 14 on adults. Two trials included patients receiving radiation. Ten out of 17 trials (59%) had a high risk of bias. Strongest evidence with highest certainty was found for dietary counseling to meet macronutrient requirements in reducing incidence of radiotherapy-related nausea and vomiting in adults (n=2 studies; n=124 participants; GRADE level: moderate). There was also moderate certainty in the beneficial effect of protein supplementation on nausea and vomiting incidence in adults during radiotherapy (n=2 studies; n=124 participants; GRADE level: moderate). A significant positive effect on CINV incidence and/or severity in adults was also found for dietary counseling to meet macronutrient requirements during chemotherapy, a peppermint drink, scaly wood mushroom, chamomile, protein with ginger, and a colorless odorless diet (GRADE level: low to very low).
CONCLUSIONS
The review identified food-based approaches that could improve the nausea and vomiting experience in patients with cancer and provide guidance to clinicians. However, confidence in these findings was low and studies were heterogeneous and mostly of low quality, requiring further investigation before stronger recommendations can be made. Future research is needed to confirm efficacy and safety.
TRIAL REGISTRATION
PROSPERO CRD42022341154.
Topics: Child; Adult; Humans; Vomiting; Nausea; Antiemetics; Neoplasms; Chemoradiotherapy
PubMed: 37351633
DOI: 10.1007/s00520-023-07879-0 -
Supportive Care in Cancer : Official... Aug 2023Although there have been reports of chemotherapy-induced nausea and vomiting (CINV) beyond 120 h, its overall prevalence has not been systematically examined. The aim... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Although there have been reports of chemotherapy-induced nausea and vomiting (CINV) beyond 120 h, its overall prevalence has not been systematically examined. The aim of this review and meta-analysis was to report on the prevalence of this long-delayed CINV.
METHODS
This review was registered on PROSPERO (CRD42022346963). PubMed (Medline), Embase, and Cochrane Central were searched from inception until August 2022. Articles were included if they reported on CINV > 120 h after initiation of the chemotherapy regimen and patients received a single-agent highly emetogenic (HEC) or moderately emetogenic (MEC) antineoplastic agent for 1 day alone or in combination with low/minimal emetogenic chemotherapy. For all eligible articles, individual study authors were contacted and requested to provide individual patient-level data of demographics, emetogenicity of chemotherapy regimens, and daily incidence of nausea and vomiting. Forward stepwise logistic regression identified predictors for the incident day's CINV based on prior day's CINV episodes, controlling for patient demographics, and stratified by regimen emetogenicity.
RESULTS
A total of 2048 patients from 2 studies were included in this individual patient data meta-analysis: 1333 patients (65%) received HEC and 715 (35%) received MEC. Among those receiving HEC, 325 (24%) experienced acute, 652 (49%) delayed, and 393 (31%) long-delayed nausea; 107 (8%) experienced acute, 179 (14%) delayed, and 79 (6%) long-delayed vomiting. Among those receiving MEC, 48 (7%) experienced acute, 272 (38%) delayed, and 167 (24%) long-delayed nausea; 12 (2%) experienced acute, 97 (14%) delayed, and 42 (6%) long-delayed vomiting. Nausea in the long-delayed phase was as severe as in the delayed phase. Patients experiencing nausea and vomiting on days 4 and 5 were at significant risk of experiencing long-delayed CINV.
CONCLUSION
While not as prevalent as delayed nausea and vomiting, long-delayed CINV affects a significant proportion of patients and severity is similar. Patients with delayed CINV, specifically on days 4-5, are at risk of experiencing long-delayed CINV.
Topics: Humans; Antiemetics; Prevalence; Prospective Studies; Nausea; Vomiting; Antineoplastic Agents; Neoplasms
PubMed: 37535218
DOI: 10.1007/s00520-023-07978-y -
Journal of Perianesthesia Nursing :... Feb 2024This study aims to assess the impact of nonpharmacological nursing interventions on postoperative nausea and vomiting (PONV). (Review)
Review
PURPOSE
This study aims to assess the impact of nonpharmacological nursing interventions on postoperative nausea and vomiting (PONV).
DESIGN
This is a systematic review.
METHODS
MEDLINE, Web of Science, ScienceDirect, Tübitak-ULAKBİM, and TRDizin databases were searched for the following search terms, including "Postoperative Nausea and Vomiting," "Nurse," "Nursing," and "Nonpharmacological Interventions" to identify nonpharmacological nursing interventions for PONV. A systematic review of English and Turkish articles published in the period between January 1, 2012 and June 1, 2023 was conducted. The PICOT-SD method was used to determine the compatibility of the pieces with the eligibility criteria.
FINDINGS
Fifty-eight of 3,874 articles obtained from databases fulfilled the eligibility criteria. This study demonstrated that acupuncture, aromatherapy, the oral intake of ginger, listening to music, education, and visits to patients decreased the incidence of nausea and vomiting and increased the quality of life. Additionally, it was found that patients' quality of life tended to improve along with reductions in postoperative complications.
CONCLUSIONS
The results of this study support previous findings in the literature and demonstrate that nonpharmacological nursing interventions help reduce and prevent PONV. Based on our results, we suggest that nonpharmacological nursing interventions can be employed for the management of PONV in patients undergoing surgery.
Topics: Humans; Postoperative Nausea and Vomiting; Quality of Life; Antiemetics; Aromatherapy; Acupuncture Therapy
PubMed: 37865902
DOI: 10.1016/j.jopan.2023.06.096