NUR 5300 Module 2 Evidence Search Strategy Example

Thirty-Three Records and a Registry: A Repeatable Search and Screening Record for Inhaled Isopropyl Alcohol in Postoperative Nausea

Student Name

Master of Science in Nursing (MSN), Thomas Edison State University

NUR-5300: Evidence-Based Nursing Practice

Mentor Name

Month Day, Year

Thirty-Three Records and a Registry: A Repeatable Search and Screening Record for Inhaled Isopropyl Alcohol in Postoperative Nausea

The first module's question concerns adults who are nauseated in phase one recovery after outpatient surgery, and asks whether sniffing an alcohol pad on top of the usual rescue drug brings nausea down further, and spares more patients a second drug, inside half an hour. This paper records the search for evidence: the sources searched, the exact terms and limits, the number of records at each step, the screening decisions and the studies carried forward for appraisal. Reporting is modeled on the PRISMA 2020 statement, which Page et al. (2021) designed so that a reader can see what was searched, what was found and why studies were included or excluded.

Sources and Strategy

Four sources were searched. PubMed was searched directly on October 1, 2026, because its indexing of anesthesia and emergency medicine journals is broad. The Cochrane Library was checked for systematic reviews, since a current review would change the strategy. ClinicalTrials.gov was searched for registered trials, because unpublished and ongoing studies can reveal how settled a question really is. Finally, the reference lists of the included review and trials were scanned by hand.

The PubMed strategy combined two concepts. The condition concept joined postoperative nausea, the abbreviation PONV and the phrase postoperative nausea and vomiting with OR. The intervention concept joined aromatherapy, isopropyl alcohol, peppermint and essential oil with truncation, using OR, because studies of isopropyl alcohol are often indexed or titled as aromatherapy, and excluding the broader term would miss them. The outcome and comparison were not searched as terms, because trials describe them in too many ways; they were applied at screening instead.

The search date matters because this is an active area. A search repeated six months from now may find new trials, and recording the date lets a reader judge whether the evidence base described in the later modules is still current.

The PubMed Search Record

The table records each step and its count. Adding the intervention concept reduced nearly twenty thousand records to ninety-eight, which shows how small this literature is. Restricting to the past sixteen years removed twenty older records, many of them small studies of peppermint already covered by the systematic review. The final publication type filter kept trials, reviews and meta-analyses, leaving thirty-three records for screening.

Two limits were deliberately not applied. Language was not restricted at the search stage, so that relevant non-English trials would at least be visible; and the age filter was not used, because PubMed's age tags are applied inconsistently and could remove adult trials. Both decisions were handled at screening instead, where they could be applied with judgment.

Screening and Selection

The thirty-three records were first screened by title and abstract against criteria set before screening began: adults; treatment, not prevention, of nausea; inhaled isopropyl alcohol or aromatherapy that included an isopropyl alcohol arm; any comparison; and an outcome of nausea severity or rescue medication. Twenty-one records were excluded at this stage, most for studying prevention or children or for testing only other oils. Twelve full texts were read, and seven were excluded, three because they enrolled only obstetric or inpatient populations and four because isopropyl alcohol was not separately reported. Five sources were carried forward.

The five are the Cochrane review by Hines et al. (2018), whose pooled trials gave moderate-quality support for alcohol inhalation halving nausea sooner than standard drugs and cutting rescue doses; the surgical trial by Hunt et al. (2013), which tested several aromatherapy agents including isopropyl alcohol against saline in more than three hundred postoperative patients; the emergency department trial by April et al. (2018), which randomized patients to isopropyl alcohol with ondansetron, isopropyl alcohol with placebo, or saline with ondansetron; and two smaller trials found through reference lists. The April trial is particularly valuable because one of its arms combines isopropyl alcohol with an antiemetic, close to the intervention in my question.

Screening was done twice, a week apart, to check consistency; the two passes disagreed on one record, a small trial in mixed inpatient and outpatient surgical patients, which was retained after the full text showed that outpatients were reported separately.

Registry and Reference Searching

ClinicalTrials.gov, searched with the terms isopropyl alcohol and nausea, listed several completed and recruiting trials, most in emergency settings, and the Cochrane review itself noted registered trials without published results at the time. The registry search does not add evidence directly, but it suggests that the question is still active and that publication bias, the tendency for positive trials to be published sooner, could affect the published picture. Reference list scanning added the two smaller trials and confirmed that no major trial had been missed by the database search.

The registry also offered a practical lesson: several listed trials had completed years earlier without posted results, a reminder that the published literature may represent the more favorable findings.

Reflection on the Search

The search taught two lessons. First, the literature does not match the question exactly. No trial found tested isopropyl alcohol added to rescue antiemetics specifically in a PACU, so appraisal and synthesis will rely on neighboring evidence: postoperative trials comparing aromatherapy with saline, emergency department trials comparing isopropyl alcohol with ondansetron, and a review pooling both. Second, the field's terminology hides relevant studies; isopropyl alcohol is often labeled as aromatherapy or as a placebo control in trials of other oils, which is why the broader term was kept. The search record makes these limits visible, so the next modules can judge the evidence knowing exactly where it came from and what it leaves out.

That record is also what lets a later reader, or my own future self, update the search rather than start again.

References

April, M. D., Oliver, J. J., Davis, W. T., Ong, D., Simon, E. M., Ng, P. C., & Hunter, C. J. (2018). Aromatherapy versus oral ondansetron for antiemetic therapy among adult emergency department patients: A randomized controlled trial. Annals of Emergency Medicine, 72(2), 184-193. https://doi.org/10.1016/j.annemergmed.2018.01.016

Hines, S., Steels, E., Chang, A., & Gibbons, K. (2018). Aromatherapy for treatment of postoperative nausea and vomiting. Cochrane Database of Systematic Reviews, 2018(3), Article CD007598. https://doi.org/10.1002/14651858.CD007598.pub3

Hunt, R., Dienemann, J., Norton, H. J., Hartley, W., Hudgens, A., Stern, T., & Divine, G. (2013). Aromatherapy as treatment for postoperative nausea: A randomized trial. Anesthesia & Analgesia, 117(3), 597-604. https://doi.org/10.1213/ANE.0b013e31824a0b1c

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., . . . Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71