Nitrous oxide added at the end of isoflurane anesthesia hastens early recovery without increasing the risk for postoperative nausea and vomiting: a randomized clinical trial

Mraović, Boris; Šimurina, Tatjana; Gan, Tong J.

doi:10.1007/s12630-017-1013-y

Cited by 11 publications

(12 citation statements)

References 19 publications

(24 reference statements)

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“…There is no consistent definition of early PONV in the literature. Some studies report early PONV as PONV observed within a specified post‐operative time interval 2‐5 (ie, 0‐2 hours or 0‐4 hours), whereas others report it as PONV during the entire PACU stay 6‐9 . The risk of early PONV in prospective trials is reportedly around 20% 10,11 .…”

Section: Introductionmentioning

confidence: 99%

“…In a randomised controlled trial with 1180 patients, volatile anaesthetics were reported to have a high risk for early PONV (0‐2 hours) as compared with propofol anaesthesia, whereas being a child, early PONV and the use of post‐operative opioids were the risks for delayed PONV (2‐24 hours) 2 . Further, studies reporting early PONV are often controlled trials evaluating interventions and using a specified cohort of patients 3‐5,8 …”

Section: Introductionmentioning

confidence: 99%

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Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients

Johansson

Hultin

Myrberg

et al. 2021

Acta Anaesthesiol Scand

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Background The overall risk of post‐operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%–40%. The first episode of PONV may occur early in the post‐anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to investigate and describe the risk of early PONV in a PACU, and we hypothesised that patients and perioperative factors were associated with early PONV. Methods This single‐centre retrospective observational study was conducted in a Swedish county hospital from January to June 2017 and included adult patients who underwent surgical procedures under general anaesthesia. Perioperative data were obtained by reviewing the local registry for surgical procedures, medical records and anaesthesia and post‐operative charts. Early PONV was defined as PONV occurring up to 4 hours post‐operatively at the PACU. Any notification in the medical records, perioperative charts or the registry regarding nausea, vomiting or PONV treatment was regarded as PONV. Univariate and multivariate analyses were performed for factors associated with early PONV. Results A total of 2030 patients were included in the study, of which 9.6% (n = 194) experienced early PONV. Factors associated with a high risk of early PONV were suboptimal PONV prophylaxis, need for opioids, female sex, body mass index >35 kg m−2 and major surgery and anaesthesia time ≥60 minutes. Conclusion We found that every 10th patient under general anaesthesia experienced early PONV. Suboptimal PONV prophylaxis and previously acknowledged risk factors for PONV were associated with early PONV.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients

Johansson

Hultin

Myrberg

et al. 2021

Acta Anaesthesiol Scand

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“…These agents are administered as a single dose at the end of surgery. Ondansetron is available as an orally disintegrating film (ODF) and as an orally disintegrating tablet (ODT), which are as effective as IV ondansetron (27,28). The ODT may be useful for postdischarge administration and may be administered to children over the age of five.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, dexamethasone as a glucocorticoid is effective as ondansetron for prevention of PONV (27), and it is the most common used and studied corticosteroid (28). Dexamethasone may be beneficial because of a direct antiemetic effect and by reducing postoperative pain and the need for postoperative opioids.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Different Antiemetics on the Nausea in Early Postoperative Period After Laparoscopic Holecystectomy

Marijanović

Radunovic

2021

Serbian Journal of Experimental and Clinical Research

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Postoperative nausea and vomiting (PONV) is a patient-important outcome; patients often rate PONV as worse than postoperative pain. This clinical study was aimed to asses the efficiency of standard aniemetics administration separately or in combination in prevention of PONV in patients who underwent to the same surgical procedure - laparoscopic cholecystectomy. Also, this article could provide a novel information about the best choice for prevention and treatment of PONV. This study included 87 patients divided into four groups according to the postoperative phramacological treatment: First group was control group without treatment, Second group was group of patients with ondasetron treatment in postoperative period, Third group was group of patients with ondasetron+dexamethasone treatment, and fourth group was group of patients with dexamethasone treatment in postoperative period for nausea. PONV was distributed in Ondansetron+Dexamethasone group in the lowest percent (4.5%), which means that this conbination of antiemetics was very effective. Than, Dexamethasone group was in relation with low incidence of PONV (14.3%), and after that were Ondansetron and Control groups. Also smokers and males has lower incidence of PONV, especially in combination with Ondansetron+Dexamethasone treatment. The incidence of PONV is lower in male smokers patients who were underwent to combination of two antiemetics, ondansetron and dexamethasone compared to monotherapy and female non-smokers. Preventive strategies for PONV must include risk stratification followed by prophylactic approach and also testing the newer antiemetics. Because of the high incidence of postoperative nausea and vomiting as a patient-important outcome, the preventive strategies should be considered as serious condition which requires multimodal approach.

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“…The study by Mraovic et al 4 in this issue of the Journal examined the effect of patients' brief exposure to 70% N 2 O in the last 30 min of laparoscopic-assisted vaginal hysterectomy under isoflurane maintenance. The authors hypothesized that this intervention would lead to more rapid recovery to extubation and orientation without increasing the incidence of PONV.…”

mentioning

confidence: 99%

The gas has the last laugh

Mashari

Wąsowicz

2017

Can J Anesth/J Can Anesth

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Nitrous oxide added at the end of isoflurane anesthesia hastens early recovery without increasing the risk for postoperative nausea and vomiting: a randomized clinical trial

Abstract: Adding NO during the last 30 min of an isoflurane-based inhalational anesthetic reduced the time to extubation, eye opening, and orientation.

Cited by 11 publications

References 19 publications

Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients

Early post‐operative nausea and vomiting: A retrospective observational study of 2030 patients

The Impact of Different Antiemetics on the Nausea in Early Postoperative Period After Laparoscopic Holecystectomy

The gas has the last laugh

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