Does the efficacy of supplemental oxygen for the prevention of postoperative nausea and vomiting depend on the measured outcome, observational period or site of surgery?

Turan, Alparslan; Apfel, Christian C.; Kumpch, M.; Danzeisen, O.; Eberhart, Leopold; Forst, H.; Heringhaus, Christian; Isselhorst, C.; Trenkler, Stefan; Trick, M.; Vedder, Ina; Kerger, Heinz

doi:10.1111/j.1365-2044.2006.04703.x

Cited by 40 publications

(29 citation statements)

References 28 publications

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“…Furthermore, a large study involving 560 patients investigating the impact of O 2 on PONV concluded it has no impact on PONV regardless of the site or surgery or the observational period (early or late PONV). 33 In conclusion, we demonstrated that 70% N 2 O increases the incidence of nausea and severity of nausea at 24 h after laparoscopic gynecological surgery in the absence of any prophylactic antiemetic. This preliminary finding indicates that N 2 O may increase PONV in a dose-dependent fashion.…”

Section: Discussionmentioning

confidence: 52%

The Dose–Response of Nitrous Oxide in Postoperative Nausea in Patients Undergoing Gynecologic Laparoscopic Surgery: A Preliminary Study

Mraović¹,

Šimurina²,

Sonicki³

et al. 2008

Anesthesia &Amp; Analgesia

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N(2)O increases the incidence of postoperative nausea after gynecologic laparoscopic surgery. This preliminary finding indicates that N(2)O may increase PONV in a dose-dependent fashion. A study with a sample size of >400 patients in each group would be necessary to demonstrate a statistically significant difference among each of these three groups. We do not recommend using a high concentration of N(2)O in this clinical setting.

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Section: Discussionmentioning

confidence: 52%

The Dose–Response of Nitrous Oxide in Postoperative Nausea in Patients Undergoing Gynecologic Laparoscopic Surgery: A Preliminary Study

Mraović¹,

Šimurina²,

Sonicki³

et al. 2008

Anesthesia &Amp; Analgesia

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“…Eleven trials (2,293 patients) reported dichotomous data on presence or absence of nausea or vomiting (table 2). 6,7,27,29,30,57,59,65,67,68,71 When combining all data, only prevention of late nausea showed statistical significance in favor of high FIo 2 ( fig. 3A).…”

Section: Perioperative Medicinementioning

confidence: 98%

Effect of Intraoperative High Inspired Oxygen Fraction on Surgical Site Infection, Postoperative Nausea and Vomiting, and Pulmonary Function

et al. 2013

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Background: Intraoperative high inspired oxygen fraction (FIo 2 ) is thought to reduce the incidence of surgical site infection (SSI) and postoperative nausea and vomiting, and to promote postoperative atelectasis. Methods: The authors searched for randomized trials (till September 2012) comparing intraoperative high with normal FIo 2 in adults undergoing surgery with general anesthesia and reporting on SSI, nausea or vomiting, or pulmonary outcomes. Results: The authors included 22 trials (7,001 patients) published in 26 reports. High FIo 2 ranged from 80 to 100% (median, 80%); normal FIo 2 ranged from 30 to 40% (median, 30%). In nine trials (5,103 patients, most received prophylactic antibiotics), the incidence of SSI decreased from 14.1% with normal FIo 2 to 11.4% with high FIo 2 ; risk ratio, 0.77 (95% CI, 0.59-1.00). After colorectal surgery, the incidence of SSI decreased from 19.3 to 15.2%; risk ratio, 0.78 (95% CI, 0.60-1.02). In 11 trials (2,293 patients), the incidence of nausea decreased from 24.8% with normal FIo 2 to 19.5% with high FIo 2 ; risk ratio, 0.79 (95% CI, 0.66-0.93). In patients receiving inhalational anesthetics without prophylactic antiemetics, high FIo 2 provided a significant protective effect against both nausea and vomiting. Nine trials (3,698 patients) reported on pulmonary outcomes. The risk of atelectasis was not increased with high FIo 2 . Conclusions: Intraoperative high FIo 2 further decreases the risk of SSI in surgical patients receiving prophylactic antibiotics, has a weak beneficial effect on nausea, and does not increase the risk of postoperative atelectasis. IT has been claimed that patients undergoing surgery with general anesthesia were benefiting from a higher than normal inspired oxygen fraction (FIo 2 ).1,2 Some authors have suggested that a high FIo 2 was a simple, inexpensive, and lowrisk intervention, and that the broader use of this technique should be encouraged in patients undergoing major abdominal procedures.3 Randomized trials have reported on a reduced risk of surgical site infection (SSI) in patients who were ventilated with 80% FIo 2 during surgery. 4,5 It was also shown that patients who were ventilated with high FIo 2 intraoperatively had a reduced incidence of postoperative nausea and vomiting (PoNV). 6,7 other authors were more cautious. 8,9 Skepticism has been partly related to the fact that high FIo 2 may have deleterious What This Article Tells Us That Is New• Intraoperative high inspired oxygen fraction decreases the risk of surgical site infection in surgical patients receiving prophylactic antibiotics, has a weak beneficial effect on nausea, and does not increase the risk of postoperative atelectasis

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“…7,15,23 Other interventions that may be helpful are preoperative hydration, aggressive fluid replacement for blood loss, stimulation of acupuncture point P6, music therapy, and aromatherapy. 18 Analysis of data 30,31 on the efficacy of intraoperative supplemental oxygen in the prevention of PONV has been conflicting, and this intervention currently is not recommended.…”

Section: Prophylaxis Therapiesmentioning

confidence: 99%

Postoperative Nausea and Vomiting in Adults: Implications for Critical Care

Collins

2011

Critical Care Nurse

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Postoperative nausea and vomiting is a dreaded, uncomfortable, and unpleasant patient experience that is also a factor contributing to adverse outcomes in postoperative recovery. The key to management of this concern is to identify high-risk patients and to develop a systematic method of assessment, intervention, and evaluation within the perianesthesia care continuum. This discussion outlines the wide range of pharmacological and alternative therapies that are available in clinical practice with a case study to illustrate incorporation of these interventions in critically ill patients.

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Does the efficacy of supplemental oxygen for the prevention of postoperative nausea and vomiting depend on the measured outcome, observational period or site of surgery?

Cited by 40 publications

References 28 publications

The Dose–Response of Nitrous Oxide in Postoperative Nausea in Patients Undergoing Gynecologic Laparoscopic Surgery: A Preliminary Study

The Dose–Response of Nitrous Oxide in Postoperative Nausea in Patients Undergoing Gynecologic Laparoscopic Surgery: A Preliminary Study

Effect of Intraoperative High Inspired Oxygen Fraction on Surgical Site Infection, Postoperative Nausea and Vomiting, and Pulmonary Function

Postoperative Nausea and Vomiting in Adults: Implications for Critical Care

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