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Dopamine antagonists, 5-HT 3 antagonists, and dexamethasone are frequently used in obstetrics to prevent postoperative nausea and vomiting (PONV). However, the superiority of any drug class is yet to be established. This network meta-analysis aimed to compare the efficacy of these antiemetics for PONV prophylaxis in women receiving neuraxial morphine for Caesarean delivery. We searched PubMed, Embase, CENTRAL, Web of Science, and Wanfang Data for eligible randomised controlled trials. Primary outcomes were the incidences of postoperative nausea (PON) and postoperative vomiting (POV) within 24 h after surgery. We used a Bayesian random-effects model and calculated odds ratios with 95% credible intervals for dichotomous data. We performed sensitivity and subgroup analyses for primary outcomes. A total of 33 studies with 4238 women were included. In the primary analyses of all women, 5-HT 3 antagonists, dopamine antagonists, dexamethasone, and 5-HT 3 antagonists plus dexamethasone significantly reduced PON and POV compared with placebo, and 5-HT 3 antagonists plus dexamethasone were more effective than monotherapy. In the subgroup analyses, similar results were seen in women receiving epidural morphine or intrathecal morphine alone but not in women receiving intrathecal morphine with fentanyl or sufentanil. However, most included studies had some concerns or a high risk of bias, and the overall certainty of the evidence was low or very low. Combined 5-HT 3 antagonists plus dexamethasone are more effective than monotherapy in preventing PONV associated with neuraxial morphine after Caesarean delivery. Future studies are needed to determine the role of prophylactic antiemetics in women receiving intrathecal morphine and lipophilic opioids. PROSPERO CRD42023454602. [ABSTRACT FROM AUTHOR]

[Display omitted] • Both HF-NMR and LF-NMR methods were used to analyze edible bird's nests. • Forty-one components were identified and quantified and the nutrients were analyzed. • The geographical markers of each origin were accurately identified by using pattern recognition. • Adulteration was effectively identified through the LF-NMR method. Edible bird's nest (EBN) is a high-value health food with various nutrients and bioactive components. With increasing demand for EBN, they are often adulterated with cheaper ingredients or falsely labeled by the origin information, thus harming consumer interests. In this study, high- and low-field nuclear magnetic resonance (HF/LF-NMR) technology combined with multivariate statistical analysis was used to identify the geographical marker of EBN from different origins and authenticate the adulterated EBN with various adulterants at different adulteration rates. Authentic EBN samples from Malaysia were used to simulate adulteration using gelatin (GL), agar (AG) and starch (ST) at 10 %, 20 %, 40 %, 60 %, 80 %, and 100 % w/w, respectively. The results showed significant differences in composition among EBN from different origins, with isocaproate and citric acid serving as geographical markers for Malaysia and Vietnam, respectively. Leucine, glutamic acid, and N-acetylglycoprotein serving as geographical markers for Indonesia. In addition, PLS model further verified the accuracy of origin identification of EBN. The LF-NMR results of adulteration EBN showed a linear correlation between the transverse relaxation (T 2 , S 2) and the adulterated ratio. The OPLS-DA based on T 2 spectra could accurately identify authentic EBN from adulterated with GL, AG and ST at 40 %, 20 %, and 20 %, respectively. Fisher discrimination model was able to differentiate at 20 %, 20 %, and 40 %, respectively. These results show that the 1H NMR combined with multivariate statistical analysis method could be a potential tool for the detection of origin and adulteration of EBN. [ABSTRACT FROM AUTHOR]