Onyando 2014.

Methods	Design: double‐blind, prospective randomized controlled trial Country: Kenya Multisite: no International: no Treatment duration: preoperative period Follow‐up: 24 hours postoperatively Operative procedure(s): gynaecological surgery Randomization unit: participants Analysis unit: individual
Participants	60 participants enrolled ASA I to II female participants aged 18 to 65 years undergoing elective gynaecologic surgery Exclusion criteria included: a history of smoking; PONV or motion sickness, or both; hypertension; diabetes; heart disease; epilepsy; mental disability; participants undergoing emergency procedures; having regional anaesthesia were excluded; pregnancy; prisoners; participants who experienced intraoperative hypotension or significant blood loss (requiring transfusion); those given an enema for bowel prep before surgery. Randomized to: group 1 (n = 30, 50%); group 2 (n = 30, 50%). Main characteristics of participants: age (mean, standard deviation): group 1 39 years, 11.34; group 2 39.03 years, 11.33; number of females/males: 60/0.
Interventions	Group 1 (control): no preoperative bolus Group 2 (intervention): preoperative bolus of Ringer's lactate in an amount equal to the hours fasting multiplied by the patient's maintenance fluid requirement per hour up to 1000 mL Co‐interventions: none stated
Outcomes	Nausea was assessed using a 10‐point visual analogue scale, but only if a participant volunteered symptoms of nausea to a nurse. It was reported as a dichotomous outcome for the PACU stay, at 12 hours, and at 24 hours. Vomiting was recorded and reported at the same time points. Antiemetic administration was reported for the entire 24‐hour postoperative period. Systolic blood pressure, diastolic blood pressure, and heart rate were recorded and reported at the following times: pre‐induction and at 5, 15, 30, 45, 60, 75, and 90 minutes post‐intubation.
Notes	Trial registration: not stated Funder: not stated A priori sample size estimation: stated on page 13 Conducted: dates not stated Declared conflicts of interest: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomization was completed using a computer‐generated table of random numbers.
Allocation concealment (selection bias)	Unclear risk	Randomization was completed using a computer‐generated table of random numbers.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Study participants, the anaesthetist, PACU nurses, and post‐surgical ward nurses were unaware of the group assignments.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Postoperative care nurses documented outcomes and were blinded 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	Unclear risk	The duration of anaesthesia was significantly shorter for the experimental group.