Abstract | BACKGROUND: Inclusion of nitrous oxide in the gas mixture has been implicated in postoperative nausea and vomiting ( PONV) in numerous studies. However, these studies have not examined whether duration of exposure was a significant covariate. This distinction might affect the future place of nitrous oxide in clinical practice. METHODS: PubMed listed journals reporting trials in which patients randomized to a nitrous oxide or nitrous oxide-free anesthetic for surgery were included, where the incidence of PONV within the first 24 postoperative hours and mean duration of anesthesia was reported. Meta-regression of the log risk ratio for PONV with nitrous oxide (lnRR PONVN2O) versus duration was performed. RESULTS: Twenty-nine studies in 27 articles met the inclusion criteria, randomizing 10,317 patients. There was a significant relationship between lnRR PONVN2O and duration (r = 0.51, P = 0.002). Risk ratio PONV increased 20% per hour of nitrous oxide after 45 min. The number needed to treat to prevent PONV by avoiding nitrous oxide was 128, 23, and 9 where duration was less than 1, 1 to 2, and over 2 h, respectively. The risk ratio for the overall effect of nitrous oxide on PONV was 1.21 (CIs, 1.04-1.40); P = 0.014. CONCLUSIONS:
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Authors | Philip J Peyton, Christine Yx Wu |
Journal | Anesthesiology
(Anesthesiology)
Vol. 120
Issue 5
Pg. 1137-45
(May 2014)
ISSN: 1528-1175 [Electronic] United States |
PMID | 24401771
(Publication Type: Journal Article, Meta-Analysis)
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Chemical References |
- Anesthetics, Inhalation
- Nitrous Oxide
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Topics |
- Anesthetics, Inhalation
(administration & dosage, adverse effects)
- Humans
- Nitrous Oxide
(administration & dosage, adverse effects)
- Postoperative Nausea and Vomiting
(chemically induced, diagnosis)
- Randomized Controlled Trials as Topic
(methods)
- Regression Analysis
- Time Factors
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