Effect of intra-operative high inspired fraction of oxygen on postoperative nausea and vomiting in children undergoing surgery: A prospective randomised double-blind study.
Eur J Anaesthesiol 2021;
38:1124-1129. [PMID:
34313610 DOI:
10.1097/eja.0000000000001577]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND
Administration of high inspired fraction of oxygen (FiO2) during anaesthesia has been proposed to decrease postoperative nausea and vomiting (PONV) in adults but has not been extensively studied in children.
OBJECTIVES
The primary objective of this study was to evaluate the effect of 80% FiO2 on the incidence of PONV in children undergoing surgery.
DESIGN
Prospective, randomised, study.
SETTING
Single-centre, teaching hospital.
PATIENTS
Children of either gender in the age group of 5 to 15 years scheduled for elective surgeries were assessed for eligibility. In cases of emergency surgeries; patients receiving supplemental oxygen pre-operatively or on mechanical ventilation; sepsis; bowel obstruction or ischaemia; poor nutritional status; anaemia (Hb <8 g%) or surgeries lasting less than 1 h or greater than 4 h were excluded from the study.
INTERVENTIONS
After induction of anaesthesia, children were randomised to receive either 30 or 80% oxygen in air, till the end of surgery.
MAIN OUTCOME MEASURES
Incidence of PONV within 24 h; surgical site infections (SSI)s; serum serotonin and TNF-α levels and the incidence of postoperative pulmonary complications (PPC)s were studied.
RESULTS
The overall 24 h incidence of PONV was not different between the low and high FiO2 groups [24 vs. 23%; P = 0.84; odds ratio (OR) 0.92; 95% confidence interval (CI), 0.44 to 2.06]. The incidence of SSIs (15 vs. 12%; P = 0.61; OR 0.77; 95% CI, 0.28 to 2.10) and PPCs (12 vs. 8%; P = 0.38; OR 0.59; 95% CI, 0.18 to 1.92) were not significant between the low and high FiO2 groups, respectively. Intragroup and intergroup comparisons of serum serotonin and TNF-α showed no significant difference either at baseline or at the end of surgery.
CONCLUSION
High intra-operative FiO2 of 80% does not provide additional protection against PONV in children.
TRIAL REGISTRATION
The study was registered with Clinical Trials Registry of India (CTRI) with trial registration no: CTRI/2018/07/014974.
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