Incidence of postoperative nausea and emetic episodes after xenon anaesthesia compared with propofol-based anaesthesia.
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-HT(3)) receptor. As 5-HT(3) 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) microg 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).


CONCLUSIONS
Despite knowing the 5-HT(3) antagonistic properties of xenon, its use is associated with a higher incidence of nausea and emetic episodes compared with TIVA with propofol.
Coburn
M
M
Department of Anaesthesiology, University Hospital Aachen of the RWTH Aachen, Pauwelsstreet 30, D-52072 Aachen, Germany. mcoburn@ukaachen.de
Kunitz
O
O
Apfel
C C
CC
Hein
M
M
Fries
M
M
Rossaint
R
R
D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced*; D015742:Propofol / Q000009:adverse effects*; D012307:Risk Factors; D012737:Sex Factors; D014978:Xenon / Q000009:adverse effects*
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D014978:Xenon; D015742:Propofol