The incidence of post-operative nausea and vomiting is about 30% lower following xenon anesthesia compared with traditional volatile anesthesia.

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• M S Schaefer, C C Apfel, H-J Sachs, R Stuttmann, B Bein, P H Tonner, M Hein, M Neukirchen, M Reyle-Hahn, and P Kienbaum.
• Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Germany maximilian.schaefer@med.uni-duesseldorf.de.
• Br J Anaesth. 2015 Jul 1;115(1):61-7.

BackgroundIn 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.MethodsWith 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.ResultsFour 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).ConclusionsThe 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.Clinical Trial RegistrationGerman Federal Institute for Drugs and Medical Devices number AL-PMS-01/07GER.© The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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