Vol. 1 No. 3 (2025), Original Article
Vol. 1 No. 3 (2025)

Efficacy and Safety of Penehyclidine Hydrochloride in Postoperative Nausea and Vomiting Prevention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Original Article
Published 2025-04-27
Ahmed Magdy
Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt. image/svg+xml
Eithar Alqady
Faculty of Medicine, Assiut University, Assiut, Egypt. image/svg+xml
Mohamed Wagdy
Faculty of Medicine, Modern University for Technology and Information, Cairo, Egypt. image/svg+xml
Ahmed T.shalby
Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt. image/svg+xml
Mahmoud Abdelkader
Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Zagazig University, Alsharkia, Egypt. image/svg+xml
Karim Osamy
Department of Anesthesia, Sharjah Hospital, Emirate Health Services, Sharjah, UAE. image/svg+xml
Alaa Anter
Faculty of Medicine, Alexandria University, Alexandria, Egypt.. image/svg+xml
IhabTarik
Faculty of Medicine, Tanta University, Tanta, Gharbia, Egypt. image/svg+xml
Manar Samy
Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Sherif Eltawansy
Internal Medicine Department, Jersey Shore University Medical Center, Neptune, NJ, USA. image/svg+xml
Ahmed Hassan
Department of Cardiology, Suez Medical Complex, Suez, Egypt.
https://orcid.org/0009-0006-3800-8667
ASIDE IM issue 3
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Keywords

Penehyclidine hydrochloride
Postoperative nausea and vomiting
Systematic Review
Meta-analysis

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Magdy A, Eithar Alqady, Mohamed Wagdy, et al. Efficacy and Safety of Penehyclidine Hydrochloride in Postoperative Nausea and Vomiting Prevention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. ASIDE Int Med. 2025;1(3):14-20. doi:10.71079/ASIDE.IM.04272547
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Abstract

Introduction: Postoperative nausea and vomiting (PONV) is a common complication following anesthesia. Penehyclidine hydrochloride (PHC), an anticholinergic medication, selectively inhibits the M1 Muscarinic and M3 Muscarinic receptors involved in the nausea and vomiting pathways. This study aims to evaluate the efficacy of PHC in preventing PONV and its potential advantages over existing treatments.

Methods: This study investigated the efficacy and safety of PHC in preventing PONV by analyzing randomized controlled trials (RCTs) identified through a comprehensive search of the PubMed, Scopus, Web of Science, and Cochrane Library databases up to December 2024.

Results: Five RCTs involving 979 patients were included. Compared to the control group, PHC reduced the incidence of PONV in the first 24-72 hours after surgery (RR: 0.64, 95% CI [0.50, 0.82], p = 0.0004) and the requirement of rescue antiemetics (RR: 0.46, 95% CI [0.22, 0.96], p = 0.04). However, PHC significantly increased the incidence of dry mouth (RR: 2.64, 95% CI [1.98, 3.5], p < 0.00001). No significant differences were observed between the two groups regarding other secondary outcomes. Risk of bias assessment was done using RoB2.

Conclusions: PHC shows promising efficacy in reducing PONV and the need for antiemetic medications. Further large-scale RCTs are necessary to verify these results and determine the optimal dose.

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Supplementary File

References

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