This prospective randomized study demonstrates that opioid-free TIVA is associated with a large reduction in relative risk of PONV compared with balanced anaesthesia. Clinical trial registration NCT 01449708 (ClinicalTrials.gov).

Despite a high prevalence of esophageal dysmotility in our morbidly obese study population, there was a conspicuous absence of symptoms. Although the patients in this study were not directly questioned with regard to esophageal symptoms, several studies in the literature support our conclusion.

REFERENCES 1. Fernández-Guisasola J, Gómez-Arnau JI, Cabrera Y, et al. Association between nitrous oxide and the incidence of postoperative nausea and vomiting in adults: a systematic review and meta-analysis. Anaesthesia. 2010;65:379-387. 2. Orhan-Sungur M, Apfel C, Akça O. Effects of nitrous oxide on intraoperative bowel distension.

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