title: Predictors for postoperative nausea and vomiting after xenon-based anaesthesia.
abstract: BACKGROUND
  In contrast to volatile anaesthetics, xenon acts by antagonism at N-methyl-d-aspartate receptors and antagonizes 5-hydroxytryptamine type 3 receptors that mediate nausea and vomiting. Therefore, it is unknown whether the same risk factors for postoperative nausea and vomiting (PONV) after volatile anaesthetics apply to xenon-based anaesthesia.
  
  
  METHODS
  With ethics committee approval and written informed consent, 502 consecutive patients undergoing xenon-based anaesthesia were included in a multicentre prospective observational study. Antiemetic prophylaxis was administered at the discretion of the attending anaesthetists. Postoperative nausea and vomiting and need for antiemetic rescue medication were assessed for 24 h after anaesthesia. Multivariate logistic regression analysis was performed to quantify risk factors for PONV and need for rescue medication.
  
  
  RESULTS
  Four hundred and eighty-eight subjects were available for the final analysis. The incidence of PONV in subjects without prophylaxis was lower than expected according to the Apfel Score (28% observed; 42% expected, P<0.001). Independent predictors for PONV were (adjusted odds ratio; 95% confidence interval) female sex (1.76; 1.08-2.89), younger patient age (0.82 per 10 yr; 0.69-0.97), and longer duration of anaesthesia (1.36 per hour; 1.17-1.59).
  
  
  CONCLUSIONS
  The incidence of PONV was significantly lower than predicted by the Apfel Score. Female sex, younger age, and longer duration of anaesthesia are risk factors for PONV after xenon-based anaesthesia.
  
  
  BACKGROUND
  German Federal Institute for Drugs and Medical Devices number AL-PMS-01/07GER.
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Germany maximilian.schaefer@med.uni-duesseldorf.de.
authors.forename: M S
authors.initials: MS
authors.lastname: Schaefer
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Apfel
authors.affiliation: Klinik für Anästhesie und Perioperative Medizin, Interdisziplinäre Intensivmedizin, Evangelisches Waldkrankenhaus Berlin-Spandau, Germany.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Sachs
authors.affiliation: Klinik für Anästhesiologie, Intensiv- und Notfallmedizin, Schmerztherapie Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Stuttmann
authors.affiliation: Klinik für Anästhesiologie und Operative Intensivmedizin, Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Bein
authors.affiliation: Klinik für Anästhesie, Operative und Allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen, Germany.
authors.forename: P H
authors.initials: PH
authors.lastname: Tonner
authors.affiliation: Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Aachen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hein
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Neukirchen
authors.affiliation: Klinik für Anästhesie und Perioperative Medizin, Interdisziplinäre Intensivmedizin, Evangelisches Waldkrankenhaus Berlin-Spandau, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Reyle-Hahn
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Kienbaum
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced* / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014978:Xenon / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D014978:Xenon
keywords: anaesthetics; antiemetics; risk factors