BJA Advance Access originally published online on April 8, 2008
British Journal of Anaesthesia 2008 100(6):787-791; doi:10.1093/bja/aen077
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Incidence of postoperative nausea and emetic episodes after xenon anaesthesia compared with propofol-based anaesthesia
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1 Department of Anaesthesiology, University Hospital Aachen of the RWTH Aachen, Pauwelsstreet 30, D-52072 Aachen, Germany
2 Department of Anaesthesia and Intensive Care Medicine, Mutterhaus der Borromäerinnen Medical Centre, Trier, Germany
3 Perioperative Clinical Research Core, Department of Anaesthesia and Perioperative Care, University of California, San Francisco, CA, USA
* Corresponding author. E-mail: mcoburn{at}ukaachen.de
Background: Xenon has been proved to be safe and efficacious for general anaesthesia in numerous trials. In addition, experimental studies demonstrate that xenon inhibits the 5-hydroxytryptamine type 3 (5-HT3) receptor. As 5-HT3 receptor antagonists are known to decrease postoperative nausea and vomiting (PONV) to an extent comparable with a propofol-based total i.v. technique, we tested the hypothesis that general anaesthesia with xenon would result in a reduced incidence of PONV similar to that observed with propofol-based anaesthesia.
Methods: After obtaining approval from the local ethics committee and written informed consent, 142 patients were randomized to receive xenon anaesthesia or propofol-based total i.v. anaesthesia (TIVA), both supplemented with remifentanil. The incidence of postoperative nausea and emetic episodes was recorded in the post-anaesthesia care unit and on the ward more than 24 h after anaesthesia.
Results: A total of 142 patients were equally distributed between the xenon and TIVA groups. Anaesthesia was maintained with mean (SD) concentrations of either xenon 61 (2)% or propofol 100 (20) µg kg–1 min–1. Incidences of nausea and emetic episodes over the whole 24-h period were 66.2% and 35.2% in the xenon group and 26.8% and 16.9% in the TIVA group (P<0.001 and P<0.021).
Conclusion: Despite knowing the 5-HT3 antagonistic properties of xenon, its use is associated with a higher incidence of nausea and emetic episodes compared with TIVA with propofol.
Keywords: anaesthetics, xenon; anaesthetics, i.v., propofol; recovery, postoperative; vomiting, nausea, anaesthetic factors
Drs M. Coburn and O. Kunitz contributed equally to this study.
Declaration of interest. Dr M. Coburn and Professor R. Rossaint are paid consultants of Air Liquide Santé International, a company interested in developing clinical applications for medical gases, including xenon.