Does perioperative intravenous dextrose reduce postoperative nausea and vomiting? A systematic review and meta-analysis

Figures & data

Figure 1 Meta-analysis flow chart.

Abbreviation: RCT, randomized controlled trial.

Table 1 The main characteristics of the studies included in the meta-analysis

	Number (control, dextrose)	Incidence of PONV (control, dextrose)	Population (ASA, sex, age [control], age [dextrose])	Type of surgery	Control fluid	Dextrose fluid	Timing of intervention
Atashkhoei et al^Citation10	70 (35, 35)	16/35, 8/35	1, female, 32.09 (±1.02) 30.49 (±0.91)	Diagnostic laparoscopy for infertility	Ringer’s lactate 714.7 mL (10 mL kg^−1 h^−1)	5% dextrose in Ringer’s lactate 608.1 mL(10 mL kg^−1 h^−1)	Intraoperatively
Dabu-Bondoc et al^Citation11	62 (32, 30)	20/32, 14/30	1–2, female, 37.5 (±9.8) 37.9 (±10.3)	Gynecologic, laparoscopic and hysteroscopic procedures	Ringer’s lactate 1,000 mL	5% dextrose in Ringer’s lactate 1,000 mL	Immediately after surgery (in the PACU), >30 minutes
Firouzian et al^Citation12	121 (60, 61)	NA	1–2, female, 41.44 (±12.75) 41.2 (±12.73)	Laparoscopic cholecystectomy	Ringer’s lactate 500 mL	5% dextrose in Ringer’s lactate 500 mL	30 minutes before induction of anesthesia, >30 minutes
McCaul et al^Citation13	71 (36, 35)	6/36, 10/35	1, female, 32.3 (±4.96) 33.2 (±4.9)	Elective gynecological laparoscopy	Ringer’s lactate 1,115 (±363) mL (1.5 mL kg^−1 h^−1 of fasting)	5% dextrose in Ringer’s lactate 1,148 (±210) mL (1.5 mL kg^−1 h^−1 of fasting)	After induction of anesthesia, >20 minutes
Mishra et al^Citation14	100 (50, 50)	33/50, 14/50	1–2, female and male, 39.6 (±11.54) 37.42 (±12.00)	Laparoscopic cholecystectomy	0.9% saline 250 mL	5% dextrose <108 mL (100 mL h^−1)	Initiation upon gallbladder removal, continued until surgery completion
Patel et al^Citation15	162 (75, 87)	38/75, 47/87	1–2, female, 45.5 (43.0–47.9) 46.3 (43.7–48.9)	Gynecologic, urologic or breast surgery	Ringer’s lactate 250 mL	5% dextrose in Ringer’s lactate 250 mL	Initiated with surgical closure, >2 hours
Rao et al^Citation16	115 (59, 56)	43/59, 24/56	1–2, female and male, 43 (±13) 44 (±11)	Laparoscopic cholecystectomy	Ringer’s lactate 1,000 mL	5% dextrose 1,000 mL	After the end of surgery in the PACU, >30 minutes

Note: Ages are presented as mean (±SD), or mean (95% CI).

Abbreviations: ASA, American Society of Anesthesiologists physical status classification; NA, not applicable; PACU, postanesthesia care unit; PONV, postoperative nausea and vomiting.

Figure 2 Risk of bias of original studies.

Figure 3 Forest plot of the effects of perioperative intravenous dextrose administration on the risk for postoperative nausea and vomiting according to the type of surgery.

Figure 4 Forest plot of the effects of perioperative intravenous dextrose administration on the risk for postoperative vomiting according to the type of surgery.

Figure 5 Forest plot of the effects of perioperative intravenous dextrose administration on the requirement for anti-emetic therapy according to the type of surgery.

Figure 6 Forest plot of the effect of perioperative intravenous dextrose administration on the risk for postoperative nausea and vomiting stratified by the volume of dextrose fluid.

Figure 7 Forest plot of the effects of perioperative intravenous dextrose administration on postoperative glucose levels (mg dL⁻¹).

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