Systematic review critique

Topics: Anesthesia, Opioid, Vomiting Pages: 3 (926 words) Published: February 2, 2014

Critique of Systematic Review of intravenous acetaminophen

Chamberlain College of Nursing
NR505: Advance Research Methods: Evidence-Based Practice
Fall Session A, 2013
According to the systematic review covered by Apfel, Turan, Souza, Pergolizzi & Hornuss, 2013 there is a significant reduction in postoperative nausea and vomiting and opioid use when using intravenous acetaminophen. The reviewers used Medline and Cochrane databases to conduct their search along with a hand search of abstracts to identify randomized-controlled trials using intravenous acetaminophen. The review was to determine if the acetaminophen was going to have a significant decline in nausea and vomiting following surgical procedures as this is a large concern for patients following their procedures. While the studies were testing for postoperative nausea and vomiting what they were able to find was also better pain control in some instances. But with this systematic review it was clear that the studies included various different outcomes depending on a multitude of scenarios.

By using randomized-controlled trials for the articles being researched in the systematic review they were utilized the highest level of evidence. The group ensured that the study was conducted in compliance with the preferred reporting items for systematic reviews and meta-analysis, or PRISMA. After the initial search revealed 217 references they began to exclude various references which left them with a total of 30 papers. Included in these 30 papers were a total of 2364 patients total with 1223 being the acetaminophen group and 1441 in the placebo group. The research articles all included reports of nausea or vomiting. The hard part was finding a patient that experienced one without the other as usually patients experience the symptoms together. Most do not experience vomiting without...

References: Apfel, C., Turan, A., Souza, K., Pergolizzi, J., & Hornuss, C. (2013). Intravenous acetaminophen
reduces postoperative nausea and vomiting: A systematic review and meta-analysis. Pain,
154(5), 677-689. doi: 10.1016/j.pain.2012.12.025
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews
and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006–1012
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