Summary of findings 3. Isopropyl alcohol compared to standard treatment for postoperative nausea and vomiting.
| Isopropyl alcohol compared to standard treatment for postoperative nausea and vomiting | ||||||
| Patient or population: adults and children having any type of surgical procedure under general anaesthesia, regional anaesthesia or sedation, as hospital inpatients or outpatients, with existing PONV Setting: hospital post‐anaesthesia care unit or same‐day surgery unit in USA Intervention: isopropyl alcohol Comparison: standard treatment for PONV | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with standard treatment for PONV | Risk with isopropyl alcohol | |||||
|
Nausea severity Measured by a validated scale or medical or nursing observation |
See comment | ‐ | ‐ | ‐ | The studies reporting this comparison did not report this outcome. | |
|
Nausea duration (measured as nausea‐free at end of treatment)
Assessed by time (minutes) to 50% reduction in nausea score
Scale from: 0 to 120
Follow‐up: range 5 minutes to participant discharge Measured by participant self‐report or medical or nursing observation |
The mean time to 50% reduction in nausea score was 20.5 minutes | SMD 1.10 SD lower (1.43 lower to 0.78 lower) | ‐ | 176 (3 RCTs) | ⊕⊕⊕⊝ Moderate1 | Risk in placebo group based on Pellegrini 2009 |
| Use of rescue antiemetics Assessed by proportion requiring antiemetics Follow‐up: range 5 minutes to participant discharge | Study population | RR 0.67 (0.46 to 0.98) | 215 (4 RCTs) | ⊕⊕⊕⊝ Moderate2 | ||
| 39 per 100 | 26 per 100 (18 to 38) | |||||
|
Patient satisfaction with treatment
Assessed with Yes or No Measured by a validated scale |
Study population | RR 1.12 (0.62 to 2.03) | 172 (2 RCTs) | ⊕⊝⊝⊝ Very low1, 3, 4 | ||
| 76 per 100 | 85 per 100 (47 to 100) | |||||
|
Adverse events (common reactions to aromatherapy include skin rashes, dyspnoea, headache, cardiac arrhythmias, hypotension, hypertension or dizziness) |
See comment | ‐ | ‐ | ‐ | The studies reporting this comparison did not report this outcome. | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; PONV: postoperative nausea and vomiting; RCT: randomized controlled trial; RR: risk ratio; SD: standard deviation; SMD: standardized mean difference | ||||||
| GRADE Working Group grades of evidence High quality: we are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect | ||||||
1No or unclear blinding in all included studies, downgraded one level. 2No or unclear blinding in three of the four included studies, downgraded one level. 3High heterogeneity between studies, downgraded one level. 4High imprecision due to wide confidence intervals and small numbers of participants, downgraded one level.