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. 2020 Oct 19;2020(10):CD012859. doi: 10.1002/14651858.CD012859.pub2

Wattwil 2003.

Study characteristics
Methods Study design: randomized controlled trial
Study grouping: 2 groups, monoprophylaxis
Participants Baseline characteristics
Dexamethasone (group D)

  • Assessed for eligibility (n): ‐

  • Enrolled (n): ‐

  • Randomized (n): 40

  • Received treatment (n): NA

  • Analysed (n): 38

  • Age (mean ± SD, median (IQR), median (range)): 55 (31 to 78)

  • Weight (mean ± SD, median (IQR), median (range)): 70 (48 to 109)

  • BMI (mean ± SD, median (IQR), median (range)): 26 (18 to 43)

  • ASA I/II/III/IV (n): NA/NA/NA/0

  • Gender (female in %): 100

  • Non‐smoker (%): 71.05

  • History of PONV/motion sickness (%): NA

  • Type of general anaesthesia: inhalational anaesthesia (sevoflurane, N₂O)

  • Duration of anaesthesia or surgery (in min; as mean or median): 53

  • Use of perioperative opioids (if yes, which?): fentanyl at induction, 5 mg postoperative morphine equivalent consumption

  • Type of surgery: breast surgery for carcinoma


Ondansetron (group O)

  • Assessed for eligibility (n): ‐

  • Enrolled (n): ‐

  • Randomized (n): 40

  • Received treatment (n): NA

  • Analysed (n): 40

  • Age (mean ± SD, median (IQR), median (range)): 58 (18 to 75)

  • Weight (mean ± SD, median (IQR), median (range)): 71 (50 to 90)

  • BMI (mean ± SD, median (IQR), median (range)): 26 (19 to 34)

  • ASA I/II/III/IV (n): NA/NA/NA/0

  • Gender (female in %): 100

  • Non‐smoker (%): 80

  • History of PONV/motion sickness (%): NA

  • Type of general anaesthesia: inhalational anaesthesia (sevoflurane, N₂O)

  • Duration of anaesthesia or surgery (in min; as mean or median): 51

  • Use of perioperative opioids (if yes, which?): fentanyl at induction, 3 mg postoperative morphine equivalent consumption

  • Type of surgery: breast surgery for carcinoma


Included criteria: ASA I to III, 19 to 80 years of age, undergoing breast surgery for carcinoma
Excluded criteria: receiving preoperative steroid medication
Pretreatment: baseline characteristics (age, weight): no; (ASA): unclear. Potential effect modifiers (gender, duration of anaesthesia, perioperative opioids, non‐smoker): no; (history of PONV/motion sickness): unclear
Interventions Intervention characteristics
Dexamethasone (group D)

  • Dose: 4 mg

  • Time point of administration: immediately after induction of anaesthesia but before the start of surgery

  • Route of administration: IV

  • Rescue antiemetics (if yes, which?): 2.5% (NA)


Ondansetron (group O)

  • Dose: 4 mg

  • Time point of administration: immediately after induction of anaesthesia but before the start of surgery

  • Route of administration: IV

  • Rescue antiemetics (if yes, which?): 0% (NA)
Outcomes Vomiting (0 to 24 hours)

  • Outcome type: dichotomous outcome


Vomiting (0 to 4 hours)

  • Outcome type: dichotomous outcome


Vomiting (4 to 8 hours)

  • Outcome type: dichotomous outcome


Nausea (0 to 24 hours)

  • Outcome type: dichotomous outcome


Subjects with any AE (0 to 24 hours)

  • Outcome type: dichotomous outcome


Adverse events (general notes in the publication, 24 hours' observation)

  • Outcome type: general notes on side effects
Identification Sponsorship source: NA
Country: Sweden
Setting: in‐ and outpatient, single‐centre
Author's name: M. Wattwil
Institution: Department of Anesthesiology and Intensive Care, University Hospital, Örebro, Sweden
Email: magnus.wattwil@orebroll.se
Address: Department of Anesthesiology and Intensive Care, University Hospital, SE‐701 85 Örebro, Sweden
Duration of study: NA
Language: English
Study's primary outcome: incidence of PONV
Trial registry number: NA
Notes None
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "using computer‐generated random numbers"
Allocation concealment (selection bias) Unclear risk Quote: "using computer‐ generated random numbers inserted into sealed envelopes"
Judgement comment: not stated; "sequentially numbered, opaque, and sealed envelopes" (SNOSE)
Blinding of participants and personnel (performance bias)
All outcomes Unclear risk Quote: "patients were blinded since they received the study drug after induction of anesthesia"
Judgement comment: no information on blinding of anaesthesiologist
Blinding of outcome assessment (detection bias)
All outcomes High risk Quote: "nurses recording episodes of retching or vomiting were not blinded"
Incomplete outcome data (attrition bias)
All outcomes Low risk Quote: "eighty patients were scheduled for the study but two patients in Group D were excluded due to violation of the study protocol (one incorrect premedication and one intubation anesthesia)"
Selective reporting (reporting bias) Unclear risk Judgement comment: no reference to a study protocol or trial registry number reported
Other bias Unclear risk Quote: "demographic data and duration of operation are presented in Table 1. No differences were seen between the groups"
Judgement comment: baseline characteristics (age, weight): no; (ASA): unclear. Potential effect modifiers (gender, duration of anaesthesia, perioperative opioids, non‐smoker): no; (history of PONV/motion sickness): unclear