Effect of nabilone on nausea and vomiting after total abdominal hysterectomy.

Lewis et al. ·British Journal of Anaesthesia

No benefit demonstrated GRADE Moderate 39 citations

Samplen = 53 Pat.

Durationpostoperative observation period

ControlMetoclopramide 10 mg oral, 90 min…

EndpointPONV incidence

Blindingdoppelblind

DesignRCT (prospektiv, doppelblind)

Cannabinoidthc

Max. dose2.0 mg

Routeoral

Key finding

Nabilone did not significantly reduce postoperative nausea and vomiting compared with metoclopramide.

Summary

n=53 evaluable patients after total abdominal hysterectomy; nabilone 2mg vs. metoclopramide 10mg preoperatively; nausea incidence 73% vs. 70%, vomiting 54% vs. 67% — no significant differences between groups.

PopulationWomen under 70 years of age after total abdominal hysterectomy, n=53

InterventionNabilone 2 mg oral, 90 minutes preoperatively

ControlMetoclopramide 10 mg oral, 90 min preoperatively

OutcomeIncidence of postoperative nausea (73% vs. 70%) and vomiting (54% vs. 67%) – no significant difference between groups

Confidence in the evidence

Moderate

The third of four GRADE levels, the effect estimate is probably reliable.

Downgraded for

Imprecision

Quality profile

Sample size ★★★★★

Blinding Double-blind

Effect size No benefit

Citations / year ★★★★★

Authors

Lewis IH, Campbell DN, Barrowcliffe MP.

DOI 10.1093/bja/73.2.244↗

Design: RCT (prospektiv, doppelblind)

Abstract

In a prospective, double-blind study, we have examined the effect of preoperative nabilone on postoperative nausea and vomiting (PONV). Sixty women, less than 70 yr old, undergoing total abdominal hysterectomy, were allocated randomly to receive either nabilone 2 mg or metoclopramide 10 mg orally 90 min before induction of anaesthesia. The study was designed to detect a 50% difference in the incidence of postoperative vomiting between the two groups, with an 80% power of achieving a statistically significant result at the 5% level. Data from 53 patients were analysed: the incidences of nausea and vomiting for the metoclopramide group were 70% and 67%, respectively; the corresponding values for the nabilone group were 73% and 54%. These differences were not significant.

The impediment to action advances action. — Marcus Aurelius