Vomiting Fourteen studies[ 4 19 20 21 23 25 26 27 28 30 31 35 36 37 ] described intraoperative vomiting, and meta-analysis indicated a nonsignificant trend toward increased vomiting with bolus versus infusion (RR 1.58, 95% CI [0.96, 2.59], P = 0.069), with high heterogeneity (I2 =87%) [ Supplementary Figure 4a ], although two studies[ 24 31 ] reported an increased incidence with the use of bolus and two studies reported no apparent difference.
(2024), showed a trend toward infusion in preventing hypotension, but these were limited by significant heterogeneity, a lack of subgroup analyses according to infusion type, and the absence of TSA for testing the conclusiveness of the pooled evidence.[ 9 10 ] In the light of such limitations, the degree of certainty regarding the true superiority of infusion or bolus regimens remains undetermined.
IONV is a distressing intraoperative complication of neuraxial anesthesia and can contribute to significant patient discomfort, anxiety, and dissatisfaction with the surgical experience.[ 47 ] The incidence of IONV during CD is significantly reduced by the administration of VPs.[ 48 ] In general, most of the analyses did not reach statistical significance for increased vomiting in the bolus group; however, data are too variable to rule out this effect.