Herbal medications for surgical patients: a systematic review protocol

BMJ Open. 2017 Jul 26;7(7):e014290. doi: 10.1136/bmjopen-2016-014290. Arruda APN1, Ayala AP2, Lopes LC3,4, Bergamaschi CC3, Guimarães C3, Grossi MD3, Righesso LAR5, Agarwal A6,7, Dib RE8,9,10. Author information 1 Department of Surgery and Orthopedics, Botucatu Medical School, UNESP-Universidade Estadual Paulista, Botucatu, São Paulo, Brazil. 2 Instruction & Faculty Liaison Librarian, Gerstein Science Information Centre, University of Toronto Libraries, University of Toronto, Toronto, Ontario, Canada. 3 Ciências Biológicas e da Saúde, University of Sorocaba, Sorocaba, São Paulo, Brazil. 4 Faculdade de Ciências Farmacêuticas, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil. 5 Department of Oral & Maxillofacial Surgery, University Medical Center Mainz, Mainz, Renânia, Germany. 6 Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. 7 School of Medicine, University of Toronto, Toronto, Ontario, Canada. 8 Department of Anesthesiology, Botucatu Medical School, UNESP-Universidade Estadual Paulista, Botucatu, São Paulo, Brazil. 9 Institute of Urology, McMaster University, St. Joseph's Healthcare, Hamilton, Ontario, Canada. 10 Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, UNESP-Universidade Estadual Paulista, São José dos Campos, São Paulo, Brazil. Abstract INTRODUCTION: Postoperative nausea and vomiting (PONV) affect approximately 80% of surgical patients and is associated with increased length of hospital stay and systemic costs. Preoperative and postoperative pain, anxiety and depression are also commonly reported. Recent evidence regarding their safety and effectiveness has not been synthesised. The aim of this systematic review is to evaluate the efficacy and safety of herbal medications for the treatment and prevention of anxiety, depression, pain and PONV in patients undergoing laparoscopic, obstetrical/gynaecological and cardiovascular surgical procedures. METHODS AND ANALYSIS: The following electronic databases will be searched up to 1 October 2016 without language or publication status restrictions: CENTRAL, MEDLINE, EMBASE, CINAHL, Web of Science and LILACS. Randomised clinical trials enrolling adult surgical patients undergoing laparoscopic, obstetrical/gynaecological and cardiovascular surgeries and managed with herbal medication versus a control group (placebo, no intervention or active control) prophylactically or therapeutically will be considered eligible. Outcomes of interest will include the following: anxiety, depression, pain, nausea and vomiting. A team of reviewers will complete title and abstract screening and full-text screening for identified hits independently and in duplicate. Data extraction, risk of bias assessments and evaluation of the overall quality of evidence for each relevant outcome reported will be conducted independently and in duplicate using the Grading of Recommendations Assessment Development and Evaluation classification system. Dichotomous data will be summarised as risk ratios; continuous data will be summarised as standard average differences with 95% CIs. ETHICS AND DISSEMINATION: This is one of the first efforts to systematically summarise existing evidence evaluating the use of herbal medications in laparoscopic, obstetrical/gynaecological and cardiovascular surgical patients. The findings of this review will be disseminated through peer-reviewed publications and conference presentations. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016042838. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. KEYWORDS: GRADE; cardiac surgery; gynecologic surgery; herbal; laparoscopy; obstetrical surgery; systematic review PMID: 28751485 DOI: 10.1136/bmjopen-2016-014290 Free full text