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Acupoint Application Combined with Acupressure as an Adjunctive Therapy for Chemotherapy-Induced Nausea and Vomiting
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Prophylaxis for pediatric postoperative nausea and vomiting: a scoping review of clinical trials

Evelina Pankiv1, Alfonso E Albornoz1, Jessica Nghiem2

  • 1Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|October 5, 2023
PubMed

Insights

Prophylactic strategies for pediatric postoperative nausea and vomiting (PONV) primarily focus on pharmacologic interventions. More research is needed on nonpharmacologic and mixed approaches for pediatric PONV prevention.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Evidence-Based Medicine

Background:

  • Postoperative nausea and vomiting (PONV) is a frequent complication in pediatric patients under general anesthesia.
  • Effective prophylactic interventions are crucial for patient well-being and optimizing perioperative care.

Purpose of the Study:

  • To systematically review the evidence on prophylactic strategies for pediatric PONV.
  • To assess both pharmacologic and nonpharmacologic interventions targeting pediatric PONV.

Main Methods:

  • Comprehensive literature search across multiple databases (MEDLINE, Embase, Cochrane, etc.) up to September 2022.
  • Included 188 clinical trials investigating various PONV prophylaxis methods.
  • Identified common surgical contexts (strabismus, tonsillectomy) and assessment tools (clinical judgment).

Main Results:

  • The vast majority of trials (83%) focused on pharmacologic interventions for pediatric PONV.
  • Nonpharmacologic and mixed interventions were investigated in a smaller proportion of studies (13% and 3%, respectively).
  • Clinical judgment was the predominant method for assessing PONV in the reviewed trials.

Conclusions:

  • Current research on pediatric PONV prophylaxis is heavily weighted towards pharmacologic agents.
  • There is a significant gap in research regarding nonpharmacologic and combined prophylactic strategies.
  • Standardized assessment tools (e.g., Baxter Animated Retching Faces Scale) and concurrent evaluation of pain/adverse effects are recommended for future research.
Abstract

Keywords:
clinical trialsgeneral anesthesiapediatric anesthesiapostoperative nausea and vomitingprophylaxisscoping review

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