Background: Dexamethasone is an antiemetic alternative to ondansetron. We aimed to compare the effects of\ndexamethasone and ondansetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing\nlaparoscopic surgery.\nMethods: We searched PubMed, Embase, Medline and Cochrane Library (from inception to July 2014) for eligible\nstudies. The primary outcome was the incidence of PONV during the first 24 h after surgery. The secondary\noutcomes included PONV in the early postoperative stage (0ââ?¬â??6 h), PONV in the late postoperative stage (6ââ?¬â??24 h),\nand the postoperative anti-emetics used at both stages. We calculated pooled risk ratios (RR) and 95 % CIs using\nrandom- and fixed-effects models.\nResults: Seven trials involving 608 patients were included in this meta-analysis, which found that dexamethasone\nhad a comparable effectiveness in preventing PONV (RR, 0.91; 95 % CI, 0.73-1.13; P = 0.39) with that of ondansetron\nwithin 24 h of laparoscopic surgery, with no evidence of heterogeneity among the studies (I2 = 0 %; P = 0.71). In\nthe early postoperative stage (0ââ?¬â??6 h), ondansetron was better at decreasing PONV than dexamethasone (RR, 1.71;\n95 % CI, 1.05-2.77; P = 0.03), while in the late postoperative stage (6ââ?¬â??24 h), dexamethasone was more effective in\npreventing PONV than ondansetron (RR, 0.51; 95 % CI, 0.27-0.93; P = 0.03). There was no significant difference in\nthe postoperative anti-emetics used (RR, 0.90; 95 % CI, 0.67-1.19; P = 0.45).\nConclusions: Dexamethasone was as effective and as safe as ondansetron in preventing PONV. Dexamethasone\nshould be encouraged as an alternative to ondansetron for preventing PONV in patients undergoing laparoscopic\nsurgery.
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