Predictors for postoperative nausea and vomiting after xenon-based anaesthesia
M S Schaefer1, C C Apfel2, H-J Sachs3
1Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Germany maximilian.schaefer@med.uni-duesseldorf.de.
British Journal of Anaesthesia
|May 13, 2015
Summary
Postoperative nausea and vomiting (PONV) occurred less often with xenon anesthesia than predicted. Female sex, younger age, and longer anesthesia duration were identified as risk factors for PONV.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Xenon anesthesia differs from volatile anesthetics in its mechanisms of action, targeting N-methyl-d-aspartate and 5-hydroxytryptamine type 3 receptors.
- The risk factors for postoperative nausea and vomiting (PONV) associated with volatile anesthetics may not directly apply to xenon-based anesthesia.
Purpose of the Study:
- To investigate the incidence of PONV in patients undergoing xenon-based anesthesia.
- To identify independent predictors and quantify risk factors for PONV and the need for antiemetic rescue medication in this patient population.
Main Methods:
- A multicenter prospective observational study included 502 consecutive patients receiving xenon-based anesthesia.
- Data on PONV and antiemetic use were collected for 24 hours post-anesthesia.
- Multivariate logistic regression analysis was used to determine risk factors.
Main Results:
- The observed incidence of PONV (28%) was significantly lower than the expected rate (42%) based on the Apfel Score (P<0.001).
- Independent predictors for PONV included female sex (OR 1.76), younger patient age (OR 0.82 per 10 years), and longer anesthesia duration (OR 1.36 per hour).
Conclusions:
- Xenon-based anesthesia is associated with a lower-than-predicted incidence of PONV.
- Female sex, younger age, and longer anesthesia duration are significant risk factors for PONV in patients receiving xenon anesthesia.
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