Skip Navigation

This Article
Right arrow Full Text (PDF)
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (111)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Tramer, M.
Right arrow Articles by McQuay, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tramer, M.
Right arrow Articles by McQuay, H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

British Journal of Anaesthesia, Vol 76, Issue 2 186-193, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Omitting nitrous oxide in general anaesthesia: meta-analysis of intraoperative awareness and postoperative emesis in randomized controlled trials

M. Tramer, A. Moore and H. McQuay
Pain Research, Nuffield Department of Anaesthetics, Churchill Hospital, Headington, Oxford OX3 7LJ

We have reviewed randomized controlled trials to assess the effectiveness and safety of anaesthetics which omitted nitrous oxide (N2O) to prevent postoperative nausea and vomiting (PONV). Early and late PONV (6 and 48 h after operation, respectively), and adverse effects were evaluated using the numbers-needed-to-treat (NNT) method. In 24 reports with information on 2478 patients, the mean incidence of early and late vomiting with N2O (control) was 17% and 30%, respectively. Omitting N2O significantly reduced vomiting compared with a N2O regimen; the combined NNT to prevent both early and late vomiting with a N2O-free regimen was about 13 (95% confidence intervals (CI) 9, 30). The magnitude of the effect depended on the incidence of vomiting in controls. In studies with a baseline risk higher than the mean of all reports, the NNT to prevent both early and late vomiting with a N2O- free anaesthetic was 5 (95% CI 4, 10). When the baseline risk was lower than the mean, omitting N2O did not improve outcome. Omitting N2O had no effect on complete control of emesis or nausea. The NNT for intraoperative awareness with a N2O-free anaesthetic was 46 compared with anaesthetics where N2O was used. This clinically important risk of major harm reduces the usefulness of omitting N2O to prevent postoperative emesis.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
M. M. Ghoneim, R. I. Block, M. Haffarnan, and M. J. Mathews
Awareness During Anesthesia: Risk Factors, Causes and Sequelae: A Review of Reported Cases in the Literature
Anesth. Analg., February 1, 2009; 108(2): 527 - 535.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
K. Leslie, P. S. Myles, M. T. V. Chan, M. J. Paech, P. Peyton, A. Forbes, D. McKenzie, and the ENIGMA Trial Group
Risk factors for severe postoperative nausea and vomiting in a randomized trial of nitrous oxide-based vs nitrous oxide-free anaesthesia
Br. J. Anaesth., October 1, 2008; 101(4): 498 - 505.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
B. Mraovic, T. Simurina, Z. Sonicki, N. Skitarelic, and T. J. Gan
The Dose-Response of Nitrous Oxide in Postoperative Nausea in Patients Undergoing Gynecologic Laparoscopic Surgery: A Preliminary Study
Anesth. Analg., September 1, 2008; 107(3): 818 - 823.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
D. M. Mathews, V. Gaba, B. Zaku, and G. G. Neuman
Can Remifentanil Replace Nitrous Oxide During Anesthesia for Ambulatory Orthopedic Surgery with Desflurane and Fentanyl?
Anesth. Analg., January 1, 2008; 106(1): 101 - 108.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
T. J. Gan, T. A. Meyer, C. C. Apfel, F. Chung, P. J. Davis, A. S. Habib, V. D. Hooper, A. L. Kovac, P. Kranke, P. Myles, et al.
Society for Ambulatory Anesthesia Guidelines for the Management of Postoperative Nausea and Vomiting
Anesth. Analg., December 1, 2007; 105(6): 1615 - 1628.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
S. N. Piper, K. D. Rohm, J. Boldt, K. L. Faust, W. H. Maleck, P. Kranke, and S. W. Suttner
Inspired oxygen fraction of 0.8 compared with 0.4 does not further reduce postoperative nausea and vomiting in dolasetron-treated patients undergoing laparoscopic cholecystectomy
Br. J. Anaesth., November 1, 2006; 97(5): 647 - 653.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
T. J. Gan
Risk factors for postoperative nausea and vomiting.
Anesth. Analg., June 1, 2006; 102(6): 1884 - 1898.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. Hohlrieder, C. Keller, J. Brimacombe, S. Eschertzhuber, G. Luckner, I. Abraham, and A. von Goedecke
Middle Ear Pressure Changes During Anesthesia With or Without Nitrous Oxide are Similar Among Airway Devices
Anesth. Analg., January 1, 2006; 102(1): 319 - 321.
[Abstract] [Full Text] [PDF]

Home page
 Am J Health Syst PharmHome page
J. Golembiewski, E. Chernin, and T. Chopra
Prevention and treatment of postoperative nausea and vomiting
Am. J. Health Syst. Pharm., June 15, 2005; 62(12): 1247 - 1260.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
H J McQuay and R A Moore
Placebo
Postgrad. Med. J., March 1, 2005; 81(953): 155 - 160.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
A. S. Habib, W. D. White, S. Eubanks, T. N. Pappas, and T. J. Gan
A Randomized Comparison of a Multimodal Management Strategy Versus Combination Antiemetics for the Prevention of Postoperative Nausea and Vomiting
Anesth. Analg., July 1, 2004; 99(1): 77 - 81.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
T. J. Gan, T. Meyer, C. C. Apfel, F. Chung, P. J. Davis, S. Eubanks, A. Kovac, B. K. Philip, D. I. Sessler, J. Temo, et al.
Consensus Guidelines for Managing Postoperative Nausea and Vomiting
Anesth. Analg., July 1, 2003; 97(1): 62 - 71.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
G. Verheecke and C. C. Apfel
Early postoperative vomiting and volatile anaesthetics or nitrous oxide
Br. J. Anaesth., January 1, 2003; 90(1): 109 - 110.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
T. O. Erb, J. M. Hall, R. J. Ing, R. J. Kanter, F. H. Kern, S. R. Schulman, and T. J. Gan
Postoperative Nausea and Vomiting in Children and Adolescents Undergoing Radiofrequency Catheter Ablation: A Randomized Comparison of Propofol- and Isoflurane-Based Anesthetics
Anesth. Analg., December 1, 2002; 95(6): 1577 - 1581.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
P. T-L. Choi, S. H. Halpern, N. Malik, A. R. Jadad, M. R. Tramer, and B. Walder
Examining the Evidence in Anesthesia Literature: A Critical Appraisal of Systematic Reviews
Anesth. Analg., March 1, 2001; 92(3): 700 - 709.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
I. Henzi, B. Walder, and M. R. Tramer
Dexamethasone for the Prevention of Postoperative Nausea and Vomiting: A Quantitative Systematic Review
Anesth. Analg., January 1, 2000; 90(1): 186 - 186.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. I. Marshall and F. Chung
Discharge Criteria and Complications After Ambulatory Surgery
Anesth. Analg., March 1, 1999; 88(3): 508 - 508.
[Full Text] [PDF]

Home page
 BMJHome page
H. Mcquay and A. Moore
Placebo mania
BMJ, October 19, 1996; 313(7063): 1008a - 1008.
[Full Text]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.