Inspired oxygen fraction of 0.8 does not attenuate postoperative nausea and vomiting after strabismus surgery.
BACKGROUND
Postoperative nausea and vomiting (PONV) is a distressing problem after strabismus surgery. An inspired oxygen fraction has been reported to decrease PONV in patients after colon resection and to be more effective than ondansetron after gynecologic laparoscopy. Therefore, in a randomized, prospective, placebo-controlled study, the authors tested whether an inspired oxygen fraction of 0.8 decreases PONV in patients undergoing strabismus surgery and whether oxygen is more effective than ondansetron.


METHODS
With approval of the authors' institutional review board, 210 patients were randomly assigned to receive one of three treatments: (1) 30% inspired oxygen in air plus intravenous administration of saline, (2) 80% inspired oxygen in air plus intravenous administration of saline, or (3) 30% inspired oxygen in air plus 75 microg/kg ondansetron intravenously during induction. General anesthesia was standardized and included etomidate, alfentanil, and mivacurium for induction and sevoflurane for maintenance. PONV was evaluated 6 and 24 h postoperatively by an investigator unaware of treatment assignment.


RESULTS
Overall postoperative incidence of nausea and vomiting was 41% for inspired oxygen fraction of 0.3 plus placebo, 38% for inspired oxygen fraction of 0.8 plus placebo, and 28% for inspired oxygen fraction of 0.3 plus ondansetron, respectively (P = 0.279). Therefore, there was no statistically significant difference of PONV incidence among groups.


CONCLUSIONS
An inspired oxygen fraction of 0.8 during general anesthesia with sevoflurane does not decrease PONV in patients undergoing strabismus repair. Ondansetron also did not significantly decrease PONV in our study setting.
Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstrasse 55, D-45122 Essen, Germany. tanja.treschan@uni-essen.de
Tanja A
TA
Treschan
Christian
C
Zimmer
Christoph
C
Nass
Bernd
B
Stegen
Joachim
J
Esser
Jürgen
J
Peters
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D001239:Inhalation / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage*; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D013285:Strabismus / Q000188:drug therapy* / Q000601:surgery*
D010100:Oxygen