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Penggunaan Multimodal Antiemetik Dalam Pencegahan Post Operative Nausea and Vomiting (PONV): Systematic Literature Review
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ABSTRACT
Postoperative nausea and vomiting (PONV) is one of the complications that often occur after surgery using general anesthesia. The attempt to prevent PONV can use a multimodal approach, which involves the use of two or more antiemetic agents with different mechanisms of action. This approach is recommended as a more effective strategy compared to monotherapy, especially for patients at high risk of PONV. This study aims to identify, evaluate, and present scientific evidence on the effectiveness of multimodal antiemetics compared to monotherapy in preventing PONV, identify the most commonly used drug combinations, and analyze the factors influencing the occurrence of PONV. This study employs a systematic literature review method with a PICOTS approach on articles found through searches in the PubMed, ScienceDirect, and Google Scholar databases. Article selection was conducted based on predetermined inclusion and exclusion criteria, and their eligibility was assessed using the JBI Critical Appraisal Tool. A total of 22 articles that met the criteria were subsequently analyzed and data were synthesized. The multimodal approach provides better effectiveness in preventing PONV. The selection of antiemetic drug combinations should be tailored to the characteristics and risks of the patient.
Keywords: Combination Antiemetic Drugs, General Anesthesia, Multimodal Antiemetic, PONV
ABSTRAK
Postoperative nausea and vomiting (PONV) merupakan salah satu komplikasi yang sering terjadi setelah pembedahan menggunakan anestesi umum. Uapaya pencegahan PONV dapat menggunakan pendekatan multimodal, yaitu penggunaan dua atau lebih agen antiemetik dengan mekanisme kerja yang berbeda. Pendekatan ini direkomendasikan sebagai strategi yang lebih efektif dibandingkan dengan monoterapi, terutama untuk pasien dengan risiko tinggi PONV.Tujuan: studi ini bertujuan untuk mengidentifikasi, mengevaluasi, dan memaparkan bukti ilmiah tentang efektivitas multimodal antiemetik dibandingkan monoterapi dalam pencegahan PONV, mengidentifikasi kombinasi obat yang paling sering digunakan, dan menganalisis mengenai faktor-faktor yang memengaruhi kejadian PONV. Metode: Penelitian ini menggunakan metode systematic literature review dengan pendekatan PICOTS terhadap artikel yang ditemukan melalui penelusuran database PubMed, ScienceDirect, dan Google Scholar. Seleksi artikel dilakukan berdasarkan kriteria inklusi dan eksklusi yang telah ditentukan, serta dinilai kelayakannya menggunakan JBI Critical Appraisal Tool. Hasil: Sebanyak 22 artikel yang memenuhi kriteria kemudian dilakukan analisis dan sintesis data. Simpulan: Pendekatan multimodal memberikan efektivitas yang lebih baik dalam pencegahan PONV. Pemilihan kombinasi obat antiemetik sebaiknya disesuaikan dengan karakteristik dan risiko pasien.
Kata Kunci: Kombinasi Antiemetik, Anestesi Umum, Multimodal Antiemetik, PONV
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DOI: https://doi.org/10.33024/mnj.v7i9.21638
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