Ismail 2017.

Methods	Design: double‐blind, prospective randomized controlled trial Country: Egypt Multisite: no International: no Treatment duration: intraoperative period Follow‐up: 24 hours postoperatively Operative procedure(s): laparoscopic cholecystectomy Randomization unit: participants Analysis unit: individual
Participants	100 participants enrolled ASA I to II participants aged 20 to 50 years undergoing laparoscopic cholecystectomy Exclusion criteria included: use of steroids, antiemetics, or opioids in the 3 days prior to surgery; liver, cardiac, or renal disease; pregnancy; body mass index > 30 kg/m2. Randomized to: group D (n = 50, 50%); group DF (n = 50, 50%); all randomized participants completed the study. Main characteristics of participants: age (mean, standard deviation): group D 34.6 years, 5.60; group DF 33.4 years, 4.96; number of females/males: 100/0.
Interventions	Group D (control): intraoperative bolus of 10 mL/kg Ringer's lactate Group DF (intervention): intraoperative bolus of 30 mL/kg Ringer's lactate Co‐interventions: both groups received dexamethasone 5 mg IV at the beginning of surgery
Outcomes	PONV was measured using a verbal descriptive scale: none, mild, moderate, or severe. Nausea, retching, and vomiting were presented as individual overall dichotomous outcomes, as well as at early (0 to 6 hour) and late (6 to 24 hour) time points. Antiemetic administration was presented as a dichotomous outcome and as total dose administered. Pain was reported on a visual analogue scale. Time to first analgesia request and total meperidine requirement were reported. Delayed complications, specifically wound infection, delayed wound healing, and inflammation or wound discharge were reported. Time required to achieve an Aldrete score of 10 was recorded.
Notes	Trial registration: NCT02726308 Funder: not stated A priori sample size estimation: stated Conducted: May 2015 to December 2015 Declared conflicts of interest: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomization was based on computer‐generated codes maintained in sequentially numbered, opaque envelopes.
Allocation concealment (selection bias)	Low risk	Randomization was based on computer‐generated codes maintained in sequentially numbered, opaque envelopes.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Participants and members of the surgical team were blind to group allocation.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Nurses collecting data in PACU were blind to group allocation.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No withdrawals were stated.
Selective reporting (reporting bias)	Low risk	All outcomes were reported.
Other bias	Low risk	There were no other sources of bias.