Evidence map›Paper›PMID 31989472›Full record

Trial reportCanadian journal of anaesthesia = Journal canadien d'anesthesie2020

The effect of intravenous dexamethasone on postoperative nausea and vomiting after Cesarean delivery with intrathecal morphine: a randomized-controlled trial.

Angela Selzer, Kane O Pryor, Virginia Tangel, Kelli O'Connell, Klaus Kjaer

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01734161 (A Prospective, Randomized, Double-Blinded Study to Evaluate the Efficacy of Intravenous Dexamethasone for Nausea Prophylaxis Prior to Duramorph and Bupivacaine Spinal Anesthesia for Scheduled Cesarean Section), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01734161 phase4completednot on this map

A Prospective, Randomized, Double-Blinded Study to Evaluate the Efficacy of Intravenous Dexamethasone for Nausea Prophylaxis Prior to Duramorph and Bupivacaine Spinal Anesthesia for Scheduled Cesarean Section

TypeinterventionalSponsorWeill Medical College of Cornell UniversityRan2012 to 2015Enrolled122ConditionsPostoperative Nausea and VomitingArmsDexamethasone, Placebo
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Angela SelzerDepartment of Anesthesiology, University of Colorado, 12401 E 17th Ave, Leprino Building, Mail Stop B113, Aurora, CO, 80045, USA. Angela.Selzer@CUAnschutz.edu.ORCID http://orcid.org/0000-0003-2241-010X
Kane O PryorDepartment of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Virginia TangelDepartment of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Kelli O'ConnellDepartment of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Klaus KjaerDepartment of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
Cornell University · USUniversity of Colorado Denver · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIntrathecal morphine administered during spinal anesthesia for Cesarean delivery is associated with a high incidence of postoperative nausea and vomiting (PONV). Small studies performed to date provide conflicting evidence on the effectiveness of dexamethasone as prophylaxis in this setting, raising the possibility that efficacy may be linked to dose timing. This study hypothesized that intravenous dexamethasone given prior to intrathecal morphine during spinal anesthesia may reduce the incidence of PONV.

methodsIn this double-blind, placebo-controlled trial, 108 patients undergoing Cesarean delivery were randomized to receive 8 mg dexamethasone or placebo prior to spinal anesthesia that included 0.2 mg intrathecal morphine. Outcomes were assessed on postanesthesia care unit arrival, as well as at postoperative hours one, three, six, 24, and 48. The primary outcome was the total number of subjects experiencing PONV during the study period of 48 hr postpartum. Secondary outcomes included severity of pain via the numeric rating scale pain score, and the use of rescue antiemetics and analgesics.

resultsNo significant difference in the number of patients experiencing PONV was found between the treatment (n = 44, 80.0%) and control groups (n = 45, 84.9%) (difference -4.9%; 95% confidence interval, -19.2 to 9.4; P = 0.50), nor for median numeric rating scale pain scores (P = 0.24), total consumption of rescue antiemetics (P = 0.40), or opioid analgesics (P = 0.26).

conclusionsThis trial does not support the use of dexamethasone prior to intrathecal morphine for PONV prophylaxis in Cesarean delivery.

trial registrationwww.clinicaltrials.gov (NCT01734161); registered 27 November, 2012.

Indexed as

Postoperative Nausea and VomitingAnalgesics, OpioidAntiemeticsDexamethasoneDouble-Blind MethodFemaleHumansInjections, SpinalMorphinePregnancyAnalgesics, OpioidAntiemeticsDexamethasoneMorphine

Identifiers

PMID31989472
OpenAlexW3002267231

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.