The effect of BIS-guided anaesthesia on the incidence of postoperative nausea and vomiting in children: a prospective randomized double-blind study
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Updated: Jun 21, 2025

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Published on: May 26, 2023
Michal Frelich1,2, Peter Sklienka1,2, Tereza Romanová1
1Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ostrava, 17.listopadu 1790, Ostrava, 708 52, Czech Republic.
Background:
Postoperative nausea and vomiting (PONV) is a significant problem following paediatric surgery, and volatile anaesthetics are an important cause of this phenomenon. BIS-guided anaesthesia, by reducing the consumption of anaesthetics, leads to a decrease in PONV in adult patients.
Study Objective:
Evaluate the role of BIS-guided anaesthesia in reducing the incidence of paediatric PONV.
Design:
Prospective, randomized, double-blind study.
Setting:
A single center study in university hospital in Czech republic, from June 2021 to November 2022.
Patients:
A total of 163 children, aged 3-8 years with ASA I-II who underwent endoscopic adenoidectomy under general anaesthesia were included.
Interventions:
In the intervention group, the depth of anaesthesia was maintained to values between 40 and 60 of BIS.
Main Outcome Measure:
The primary outcome was the incidence of postoperative nausea and vomiting during 24 h after surgery.
Results:
The use of BIS-guided anaesthesia led to a significant decrease in the incidence of nausea and vomiting compared to the control group [17% vs. 53%; RR (95%CI) 0.48 (0.27-0.86); p < 0.001and 16% vs. 34%; RR (95%CI) 0.33 (0.20-0.54); p = 0.01, respectively].
Conclusions:
BIS-guided anaesthesia decreases the incidence of postoperative nausea and vomiting in children undergoing adenoidectomy.
Trial Registration:
Clinicaltrials.gov identifier: NCT04466579.
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