In the Literature

Summary of "The effect of perioperative benzodiazepine administration on postoperative nausea and vomiting: a systematic review and meta-analysis of randomised controlled trials"

Summary published August 15, 2024

Summary by Jayashree Sood, MD; Bhuwan Chand Panday, MD

British Journal of Anaesthesia | January 2024

Au E, Zhao K, Belley-Côté E, Song Y, Al-Hazzani W, Sadeghirad B, Wang E, Young J, Kashani H, Kavosh M, Inami T, Beaver C, Kloppenburg S, Mazer D, Jacobsohn E, Um K, Spence J. The effect of perioperative benzodiazepine administration on postoperative nausea and vomiting: a systematic review and meta-analysis of randomised controlled trials. Br J Anaesth. 2024 Mar;132(3):469-482. doi: 10.1016/j.bja.2023.11.045. Epub 2024 Jan 4. PMID: 38177006.

doi: https://doi.org/10.1016/j.bja.2023.11.045

  • It is a meta-analysis that examines the benefits of benzodiazepine administration and the reduction of postoperative nausea and vomiting.
  • This analysis comprised 104 studies in which benzodiazepines were delivered intraoperatively and postoperatively. Patients were assessed for PONV in the postoperative phase.
  • The analysis with quantitative synthesis included 52 RCTs on the effect of perioperative benzodiazepines on the outcome of PONV (RR 0.77, 95% CI 0.66-0.89, P<0.0001, I²=43%, NNT 16; moderate certainty), 55 RCTs on postoperative nausea (RR 0.72, 95% CI 0.62-0.83, P<0.0001, I²=32%, NNT 21; moderate certainty), and 52 RCTs on postoperative vomiting (RR 0.74, 95% CI 0.60-0.91, P<0.0001, I²=3%, NNT 55; moderate certainty). This meta-analysis found a 23-28% reduction in PONV following perioperative benzodiazepine treatment.
  • The concept behind reduction in PONV after benzodiazepine administration is to suppress emetic pathways in the neurological system through its action on GABAA receptors.
  • The study concludes with moderate-quality evidence that perioperative benzodiazepine treatment reduces the risk of surgical nausea and vomiting, or both.