Systematic review critique Essay

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Pages: 4

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
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(Apfel et al, 2013).
When you read through the entire review it appears that the results basically end in the same result but getting to the results were started in various different manners. According to Apfel et al, 2013, postoperative nausea and vomiting occurs in approximately 30% of all patients that undergo general anesthesia with the main triggers being known to be inhalational anesthetics and/or opioids. Although they were able to find various studies due to the small size of the studies the review was unable to detect if there were any publication bias. They felt that a large more well-designed randomized-controlled trial would need to be conducted to confirm the findings (Apfel et al., 2013). Of the studies included most of the studies did not show actual reported postoperative nausea and vomiting but after the study most were able to show that there was a decrease in opioid use when using the intravenous acetaminophen therefore decreasing other adverse effects that would be noted with harder opioid use. The studies did show that if intravenous acetaminophen was given preoperative and during the surgical procedure that the antiemetic effects were increased significantly instead of waiting to treat postoperatively. And by decreasing the postoperative nausea and vomiting they noticed a decrease in reports of pain. In summary, the study was able to show that using intravenous