Lee WS 2015.

Study characteristics
Methods	Study design: randomized controlled trial Study grouping: 3 groups, monoprophylaxis
Participants	Baseline characteristics Palonosetron Assessed for eligibility (n): ‐ Enrolled (n): ‐ Randomized (n): 35 Received treatment (n): 35 Analysed (n): 35 Age (mean ± SD, median (IQR), median (range)): 51.5 ± 16.3 Weight (mean ± SD, median (IQR), median (range)): 60.1 ± 4.9 BMI (mean ± SD, median (IQR), median (range)): NA ASA I/II/III/IV (n): 23/12/0/0 Gender (female in %): 100 Non‐smoker (%): NA History of PONV/motion sickness (%): 0 Type of general anaesthesia: combined anaesthesia (propofol + remifentanil + sevoflurane + N₂O) Duration of anaesthesia or surgery (in min; as mean or median): 128.1 Use of perioperative opioids (if yes, which?): induction and maintenance of anaesthesia with remifentanil Type of surgery: laparoscopic hysterectomy Granisetron Assessed for eligibility (n): ‐ Enrolled (n): ‐ Randomized (n): 35 Received treatment (n): 35 Analysed (n): 35 Age (mean ± SD, median (IQR), median (range)): 52.5 ± 15.7 Weight (mean ± SD, median (IQR), median (range)): 59.3 ± 5.1 BMI (mean ± SD, median (IQR), median (range)): NA ASA I/II/III/IV (n): 24/11/0/0 Gender (female in %): 100 Non‐smoker (%): NA History of PONV/motion sickness (%): 0 Type of general anaesthesia: combined anaesthesia (propofol + remifentanil + sevoflurane + N₂O) Duration of anaesthesia or surgery (in min; as mean or median): 123.5 Use of perioperative opioids (if yes, which?): induction and maintenance of anaesthesia with remifentanil Type of surgery: laparoscopic hysterectomy Ramosetron Assessed for eligibility (n): ‐ Enrolled (n): ‐ Randomized (n): 35 Received treatment (n): 35 Analysed (n): 35 Age (mean ± SD, median (IQR), median (range)): 48.2 ± 12.1 Weight (mean ± SD, median (IQR), median (range)): 56.3 ± 4.3 BMI (mean ± SD, median (IQR), median (range)): NA ASA I/II/III/IV (n): 26/9/0/0 Gender (female in %): 100 Non‐smoker (%): NA History of PONV/motion sickness (%): 0 Type of general anaesthesia: combined anaesthesia (propofol + remifentanil + sevoflurane + N₂O) Duration of anaesthesia or surgery (in min; as mean or median): 120.1 Use of perioperative opioids (if yes, which?): induction and maintenance of anaesthesia with remifentanil Type of surgery: laparoscopic hysterectomy Included criteria: healthy female undergoing laparoscopic hysterectomy under general anaesthesia Excluded criteria: allergy to any of the experimental drugs, opioid dependence, history of PONV and motion sickness, use of antiemetic medication within 24 hours before surgery, pregnancy, inability to use patient‐controlled analgesia (PCA) IV device or to comprehend 10 cm visual analogue scale (VAS; 0, none; 10, maximum) for pain and nausea assessment, unwillingness to be enrolled in the study Pretreatment: baseline characteristics (age, weight, ASA): no. Potential effect modifiers (gender, duration of anaesthesia, history of PONV/motion sickness): no; (non‐smoker, perioperative opioids): unclear
Interventions	Intervention characteristics Palonosetron Dose: 0.075 mg Time point of administration: at the end of surgery, before extubation Route of administration: IV Rescue antiemetics (if yes, which?): metoclopramide 10 mg IV Granisetron Dose: 3 mg Time point of administration: at the end of surgery, before extubation Route of administration: IV Rescue antiemetics (if yes, which?): metoclopramide 10 mg IV Ramosetron Dose: 0.3 mg Time point of administration: at the end of surgery, before extubation Route of administration: IV Rescue antiemetics (if yes, which?): metoclopramide 10 mg IV
Outcomes	Vomiting (0 to 6 hours) Outcome type: dichotomous outcome Vomiting (6 to 24 hours) Outcome type: dichotomous outcome Adverse events (general notes in the publication, 48 hours' observation) Outcome type: general notes on side effects
Identification	Sponsorship source: CKDpharm Country: South Korea Setting: inpatient, single‐centre Author's name: Won‐Suk Lee Institution: Department of Anesthesiology Surgery, Gil Medical Center, Gachon University, School of Medicine, Incheon, South Korea Email: gachonlws@gmail.com Address: Department of Anesthesiology Surgery, Gil Medical Center, Gachon University, School of Medicine, Incheon, South Korea Duration of study: November 2011 to June 2013 Language: English Study's primary outcome: incidence of complete responders during the study period Trial registry number: NCT01752374
Notes	None
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "using a random number table"
Allocation concealment (selection bias)	Unclear risk	Judgement comment: no statement
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "this investigator‐initiated, prospective, non‐blinded, randomized controlled trial"
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "the incidence of nausea and vomiting was recorded during the assessment periods by ward nursing staff not blinded to the treatment drugs"
Incomplete outcome data (attrition bias) All outcomes	Low risk	Quote: "all patients completed the study"
Selective reporting (reporting bias)	Unclear risk	Judgement comment: NCT01752374 (retrospective registration)
Other bias	Unclear risk	Quote: "the groups were comparable with respect to age, weight, duration of surgery, and ASA score" Judgement comment: baseline characteristics (age, weight, ASA): no. Potential effect modifiers (gender, duration of anaesthesia, history of PONV/motion sickness): no; (non‐smoker, perioperative opioids): unclear