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dc.contributor.authorMyles PSen_US
dc.contributor.authorChan MTen_US
dc.contributor.authorKasza Jen_US
dc.contributor.authorPaech MJen_US
dc.contributor.authorLeslie Ken_US
dc.contributor.authorPeyton PJen_US
dc.contributor.authorSessler DIen_US
dc.contributor.authorHaller Gen_US
dc.contributor.authorBeattie WSen_US
dc.contributor.authorOsborne Cen_US
dc.contributor.authorSneyd JRen_US
dc.contributor.authorForbes Aen_US
dc.description.abstractBACKGROUND: The Evaluation of Nitrous oxide in the Gas Mixture for Anesthesia II trial randomly assigned 7,112 noncardiac surgery patients to a nitrous oxide or nitrous oxide-free anesthetic; severe postoperative nausea and vomiting (PONV) was a prespecified secondary end point. Thus, the authors evaluated the association between nitrous oxide, severe PONV, and effectiveness of PONV prophylaxis in this setting. METHODS: Univariate and multivariate analyses of patient, surgical, and other perioperative characteristics were used to identify the risk factors for severe PONV and to measure the impact of severe PONV on patient outcomes. RESULTS: Avoiding nitrous oxide reduced the risk of severe PONV (11 vs. 15%; risk ratio [RR], 0.74 [95% CI, 0.63 to 0.84]; P < 0.001), with a stronger effect in Asian patients (RR, 0.55 [95% CI, 0.43 to 0.69]; interaction P = 0.004) but lower effect in those who received PONV prophylaxis (RR, 0.89 [95% CI, 0.76 to 1.05]; P = 0.18). Gastrointestinal surgery was associated with an increased risk of severe PONV when compared with most other types of surgery (P < 0.001). Patients with severe PONV had lower quality of recovery scores (10.4 [95% CI, 10.2 to 10.7] vs. 13.1 [95% CI, 13.0 to 13.2], P < 0.0005); severe PONV was associated with postoperative fever (15 vs. 20%, P = 0.001). Patients with severe PONV had a longer hospital stay (adjusted hazard ratio, 1.14 [95% CI, 1.05 to 1.23], P = 0.002). CONCLUSIONS: The increased risk of PONV with nitrous oxide is near eliminated by antiemetic prophylaxis. Severe PONV, which is seen in more than 10% of patients, is associated with postoperative fever, poor quality of recovery, and prolonged hospitalization.en_US
dc.subjectAnaesthesia recovery perioden_US
dc.subjectAnaesthesia, inhalation/adverse effectsen_US
dc.subjectKaplan-Meier Estimateen_US
dc.subjectnitrous oxide/adverse effectsen_US
dc.subjectpostoperative complications/epidemiologyen_US
dc.subjecttreatment outcomeen_US
dc.subjectpostoperative nausea and vomiting/prevention & controlen_US
dc.titleSevere Nausea and Vomiting in the Evaluation of Nitrous Oxide in the Gas Mixture for Anesthesia II Trialen_US
dc.typeJournal Articleen_US
dc.type.studyortrialRandomized Controlled Clinical Trial/Controlled Clinical Trialen_US
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
Appears in Collections:Scholarly and Clinical
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