Table 3.
Level of Evidence. The level of evidence ranged from very low to low.
| Question: Nalbuphine compared to Control for the incidence of emergence delirium. | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Certainty assessment |
№ of patients |
Effect |
Certainty | ||||||||
| № of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Nalbuphine | Control | Relative (95% CI) | Absolute (95% CI) | |
| Incidence of Emergence Delirium | |||||||||||
| 7 | Randomised trials | Very seriousa | Not serious | Not serious | Seriousb | Publication bias strongly suspectedc | 86/659 (13.1%) | 228/660 (34.5%) | RR 0.38 (0.30 to 0.47) | 214 fewer per 1,000 (from 242 fewer to 183 fewer) | ⨁○○○ Very low |
| Pain Scale | |||||||||||
| 3 | Randomised trials | Not serious | Not serious | Not serious | Seriousb | Publication bias strongly suspectedc | 486 | 485 | - | MD 0.98 lower (1.92 lower to 0.04 lower) | ⨁⨁○○ Low |
| Incidence of Nausea and Vomiting | |||||||||||
| 5 | Randomised trials | Seriousd | Not serious | Not serious | Seriousb | Publication bias strongly suspectedc | 22/617 (3.6%) | 15/615 (2.4%) | RR 1.45 (0.78 to 2.70) | 11 more per 1,000 (from 5 fewer to 41 more) | ⨁○○○ Very low |
| Incidence of Desaturation | |||||||||||
| 3 | Randomised trials | Seriouse | Not serious | Not serious | Seriousb | Publication bias strongly suspectedc | 2/117 (1.7%) | 0/117 (0.0%) | RR 5.00 (0.25 to 99.95) | 0 fewer per 1,000 (from 0 fewer to 0 fewer) | ⨁○○○ Very low |
CI, Confidence Interval; MD, Mean Difference; RR, Risk Ratio.
Explanations:
a
One of the included studies is an observational study.
b
Sample group size < 400.
c
Small studies with positive results.
d
Half of the included studies possess high or unclear risk of bias.
e
All of the studies possess high or unclear risk of bias.