Predictors for postoperative nausea and vomiting after xenon-based anaesthesia.

Abstract

BACKGROUND:

In contrast to volatile anaesthetics, xenon acts by antagonism at N-methyl-d-aspartate receptors and antagonizes 5-hydroxytryptamine type 3 receptors that mediate nausea and vomiting. Therefore, it is unknown whether the same risk factors for postoperative nausea and vomiting (PONV) after volatile anaesthetics apply to xenon-based anaesthesia.

METHODS:

With ethics committee approval and written informed consent, 502 consecutive patients undergoing xenon-based anaesthesia were included in a multicentre prospective observational study. Antiemetic prophylaxis was administered at the discretion of the attending anaesthetists. Postoperative nausea and vomiting and need for antiemetic rescue medication were assessed for 24 h after anaesthesia. Multivariate logistic regression analysis was performed to quantify risk factors for PONV and need for rescue medication.

RESULTS:

Four hundred and eighty-eight subjects were available for the final analysis. The incidence of PONV in subjects without prophylaxis was lower than expected according to the Apfel Score (28% observed; 42% expected, P<0.001). Independent predictors for PONV were (adjusted odds ratio; 95% confidence interval) female sex (1.76; 1.08-2.89), younger patient age (0.82 per 10 yr; 0.69-0.97), and longer duration of anaesthesia (1.36 per hour; 1.17-1.59).

CONCLUSIONS:

The incidence of PONV was significantly lower than predicted by the Apfel Score. Female sex, younger age, and longer duration of anaesthesia are risk factors for PONV after xenon-based anaesthesia.

CLINICAL TRIAL REGISTRATION:

German Federal Institute for Drugs and Medical Devices number AL-PMS-01/07GER.

• Authors: M S Schaefer, C C Apfel, H-J Sachs, R Stuttmann, B Bein, P H Tonner, M Hein, M Neukirchen, M Reyle-Hahn, P Kienbaum
• Journal: British journal of anaesthesia (Br J Anaesth) Vol. 115 Issue 1 Pg. 61-7 (Jul 2015) ISSN: 1471-6771 [Electronic] England
• PMID: 25962612 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: [email protected].

Chemical References

• Anesthetics, Inhalation
• Xenon

Topics

• Adolescent
• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Anesthetics, Inhalation (adverse effects)
• Female
• Germany (epidemiology)
• Humans
• Incidence
• Male
• Middle Aged
• Postoperative Nausea and Vomiting (chemically induced, epidemiology)
• Prospective Studies
• Risk Factors
• Sex Factors
• Time Factors
• Xenon (adverse effects)
• Young Adult