TY - JOUR
T1 - Isopropyl alcohol inhalation versus 5-HT3 antagonists for treatment of nausea
T2 - a meta-analysis of randomised controlled trials
AU - Kimber, James S.
AU - Kovoor, Joshua G.
AU - Glynatsis, John M.
AU - West, Samuel J.
AU - Mai, Thi Thien Nhi
AU - Jacobsen, Jonathan Henry W.
AU - Ovenden, Christopher D.
AU - Bacchi, Stephen
AU - Hewitt, Joseph N.
AU - Gupta, Aashray K.
AU - Edwards, Suzanne
AU - Taverner, Fiona J.
AU - Watson, David I.
PY - 2023/11
Y1 - 2023/11
N2 - Purpose: Nausea is a common and unpleasant sensation for which current therapies such as serotonin (5-HT3) antagonists are often ineffective, while also conferring a risk of potential adverse events. Isopropyl alcohol (IPA) has been proposed as a treatment for nausea. We aimed to compare IPA with 5-HT3 antagonists for the treatment of nausea across all clinical settings. Methods: MEDLINE, EMBASE, PubMed, CENTRAL and CINAHL were searched from inception to 17 July 2023 for randomised controlled trials (RCTs) comparing inhaled IPA and a 5-HT3 antagonist for treatment of nausea. Severity and duration of nausea, rescue antiemetic use, adverse events and patient satisfaction were the outcomes sought. Risk of bias (RoB) was assessed using Cochrane RoB 2. Random-effects model was used for meta-analysis. Combination of meta-analyses and narrative review was used to synthesise findings. The evidence was appraised using GRADE. Results: From 1242 records, 4 RCTs were included with 382 participants. Participants receiving IPA had a significantly lower mean time to 50% reduction in nausea (MD − 20.06; 95% CI − 26.26, − 13.85). Nausea score reduction at 30 min was significantly greater in the IPA group (MD 21.47; 95% CI 15.47, 27.47). IPA led to significantly reduced requirement for rescue antiemetics (OR 0.60; 95% CI 0.37, 0.95; p = 0.03). IPA led to no significant difference in patient satisfaction when compared with a 5-HT3 antagonist. The overall GRADE assessment of evidence quality ranged from very low to low. Conclusion: IPA may provide rapid, effective relief of nausea when compared with 5-HT3 antagonists.
AB - Purpose: Nausea is a common and unpleasant sensation for which current therapies such as serotonin (5-HT3) antagonists are often ineffective, while also conferring a risk of potential adverse events. Isopropyl alcohol (IPA) has been proposed as a treatment for nausea. We aimed to compare IPA with 5-HT3 antagonists for the treatment of nausea across all clinical settings. Methods: MEDLINE, EMBASE, PubMed, CENTRAL and CINAHL were searched from inception to 17 July 2023 for randomised controlled trials (RCTs) comparing inhaled IPA and a 5-HT3 antagonist for treatment of nausea. Severity and duration of nausea, rescue antiemetic use, adverse events and patient satisfaction were the outcomes sought. Risk of bias (RoB) was assessed using Cochrane RoB 2. Random-effects model was used for meta-analysis. Combination of meta-analyses and narrative review was used to synthesise findings. The evidence was appraised using GRADE. Results: From 1242 records, 4 RCTs were included with 382 participants. Participants receiving IPA had a significantly lower mean time to 50% reduction in nausea (MD − 20.06; 95% CI − 26.26, − 13.85). Nausea score reduction at 30 min was significantly greater in the IPA group (MD 21.47; 95% CI 15.47, 27.47). IPA led to significantly reduced requirement for rescue antiemetics (OR 0.60; 95% CI 0.37, 0.95; p = 0.03). IPA led to no significant difference in patient satisfaction when compared with a 5-HT3 antagonist. The overall GRADE assessment of evidence quality ranged from very low to low. Conclusion: IPA may provide rapid, effective relief of nausea when compared with 5-HT3 antagonists.
KW - 5-HT3 antagonist
KW - Aromatherapy
KW - Isopropyl alcohol
KW - Nausea
UR - http://www.scopus.com/inward/record.url?scp=85171145195&partnerID=8YFLogxK
U2 - 10.1007/s00228-023-03560-x
DO - 10.1007/s00228-023-03560-x
M3 - Article
C2 - 37704796
AN - SCOPUS:85171145195
SN - 0031-6970
VL - 79
SP - 1525
EP - 1535
JO - European Journal of Clinical Pharmacology
JF - European Journal of Clinical Pharmacology
IS - 11
ER -