title: Efficacy of ondansetron vs. metoclopramide in prophylaxis of postoperative nausea and vomiting after laparoscopic cholecystectomy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The incidence of postoperative nausea and vomiting is truly high after laparoscopic cholecystectomy. Ondansetron and metoclopramide may be effective in preventing it. Our aim was to estimate the efficacy of ondansetron vs. metoclopramide in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy.
  
  
  METHODS
  We searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Science Citation Index Expanded, EMBASE etc. to obtain relevant randomized controlled trials until October 2011. Two authors independently assessed the trials for inclusion and extracted the data. The odds ratio (OR) for dichotomous data was used with 95% confidence intervals (CI). Sensitivity and subgroup analysis were performed, if necessary.
  
  
  RESULTS
  The total incidence of postoperative nausea and vomiting within 24 hours after laparoscopic cholecystectomy was 31% (74 of 235) in the ondansetron group and 56% (127 of 225) in the metoclopramide group (OR=0.33, 95%CI=0.22-0.49, p<0.00001, 12=49%). The total incidences of nausea and vomiting were lower in the ondansetron group (OR=0.28, 95%CI=0.15-0.54, p=0.0002, I²=0%) and (OR=0.31, 95%CI=0.17-0.55, p<0.0001, I²=0%), respectively.
  
  
  CONCLUSIONS
  Based on the evidence, ondansetron has a better effect than metoclopramide for preventing postoperative nausea and vomiting after laparoscopic cholecystectomy. If we ignore the price factor, ondansetron is recommended for adhibition.
authors.affiliation: Department of Bile Duct Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Si-Jia
authors.initials: SJ
authors.lastname: Wu
authors.forename: Xian-Ze
authors.initials: XZ
authors.lastname: Xiong
authors.forename: Tie-Yao
authors.initials: TY
authors.lastname: Cheng
authors.forename: Yi-Xin
authors.initials: YX
authors.lastname: Lin
authors.forename: Nan-Sheng
authors.initials: NS
authors.lastname: Cheng
mesh_terms: D000932:Antiemetics / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D016017:Odds Ratio; D017294:Ondansetron / Q000008:administration & dosage*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000932:Antiemetics; D017294:Ondansetron; D008787:Metoclopramide