International Journal of Preventive Medicine (Int J Prev Med)2008-7802149202310041641ENDepartment of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Moda1- Department of Midwifery, Faculty of Nursing and Midwifery, Islamic Azad University, Zanjan Branch, Zanjan, Iran2- Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran3- Department of Health Services Management, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran4- Department of Obstetrics and Gynecology, Dezful University of Medical Sciences, Dezful, Iran5- Department of Health and Community Medicine, Dezful University of Medical Sciences, Dezful, Iran6- Department of Nursing and Midwifery, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran20231004<p>Background: Antiemetic medications have been associated with the prevention of nausea and vomiting in cesarean section, although less is known about the comparative efficacy of different medication classes. Methods: We conducted a systematic review with network meta‑analyses to compare and rank antiemetic medication classes (5‑HT3 receptor antagonists, dopamine receptor antagonists, corticosteroids, antihistamines, anticholinergic agents, sedatives, and opioid antagonists or partial agonists) in terms of preventing intra‑ and postoperative nausea and vomiting among patients undergoing cesarean section. We included all randomized controlled trials (RCTs) that evaluated any antiemetic medication classes’ treatment for target outcomes. Network meta‑analysis was conducted with a frequentist approach using the R netmeta package. A total of 58 trials were included (6,665 women undergoing cesarean section; mean age, 28.1 years). Results: Compared with placebo, all interventions reduced the odds of intraoperative nausea (except antihistamines), intraoperative vomiting (except antihistamines), postoperative nausea (except anticholinergic agents and opioid antagonists), and postoperative vomiting (except opioid antagonists). In terms of intraoperative nausea and both intra‑ and postoperative vomiting, sedatives ranked first among other medication classes. Conclusions: The relative effect sizes for various classes of antiemetic medication in preventing nausea and vomiting in the cesarean section were modeled using the principles of network meta‑analysis which may facilitate informed clinical decision‑making.</p><p><span class="ej-journal-name" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">International Journal of Preventive Medicine<span> </span></span><span id="ej-journal-date-volume-issue-pg" style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><a style="box-sizing: border-box; color: #005b92; text-decoration: none; background-color: transparent; cursor: pointer; outline: 0px;" href="https://journals.lww.com/ijom/toc/2023/09280">14(1):116, September 2023.</a></span><span style="box-sizing: inherit; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"><span> </span>|<span> </span></span><span class="ej-journal-doi" style="box-sizing: inherit; font-style: italic; font-weight: 500; color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">DOI:<span> </span></span><span style="color: #3b3030; font-family: 'Fira Sans', sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">10.4103/ijpvm.ijpvm_250_22</span></p><p> </p><p>Corresponding Author: <span class="fontstyle0">Dr. Shiler Ahmadi</span></p><p>E‑mail: <span class="fontstyle0">ahmadi.sh64@gmail.com</span></p><p>You can also search for this author in: <a title="PubMed" href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28Shiler+Ahmadi%5BAuthor%5D+AND+Islamic+Azad+University%5BAffiliation%5D%29%29">PubMed</a>  <a title="Google Scholar" href="https://scholar.google.com/scholar?hl=en&amp;as_sdt=0%2C5&amp;q=Shiler+Ahmadi&amp;btnG=">Google Scholar</a></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2872http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2872/717718695