Evidence map›Paper›PMID 27111335›Full record

Trial reportPloS one2016

Nausea and Vomiting following Balanced Xenon Anesthesia Compared to Sevoflurane: A Post-Hoc Explorative Analysis of a Randomized Controlled Trial.

Astrid V Fahlenkamp, Christian Stoppe, Jan Cremer, Ingeborg A Biener, Dirk Peters, Ricarda Leuchter, Albrecht Eisert, Christian C Apfel, Rolf Rossaint, Mark Coburn

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00793663 (1) The Effect of Xenon and Sevoflurane on Hypnosis Monitors. 2) Prevention of Postoperative Nausea and Vomiting. 3) Rescue Treatment of Established Postoperative Nausea and Vomiting. Sevoflurane.), which is not on this map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00793663 phase4completednot on this map

1) The Effect of Xenon and Sevoflurane on Hypnosis Monitors. 2) Prevention of Postoperative Nausea and Vomiting. 3) Rescue Treatment of Established Postoperative Nausea and Vomiting. Sevoflurane.

TypeinterventionalSponsorRWTH Aachen UniversityRan2008 to 2011Enrolled220ConditionsAnaesthetics Gases, Xenon, Anaesthetics Volatile, Sevoflurane, Depth of Anaesthesia, Postoperative NauseaArmsXenon, Sevoflurane, Dexamethasone, NaCl, Ondansetron
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Astrid V FahlenkampDepartment of Anesthesiology, University Hospital Aachen, Aachen, Germany.
Christian StoppeDepartment of Anesthesiology, University Hospital Aachen, Aachen, Germany.
Jan CremerDepartment of Anesthesiology, University Hospital Aachen, Aachen, Germany.
Ingeborg A BienerDepartment of Anesthesiology, University Hospital Aachen, Aachen, Germany.
Dirk PetersDepartment of Anesthesiology, University Hospital Aachen, Aachen, Germany.
Ricarda LeuchterDepartment of Anesthesiology, University Hospital Aachen, Aachen, Germany.
Albrecht EisertHospital Pharmacy, University Hospital Aachen, Aachen, Germany.
Christian C ApfelDepartment of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, United States of America.
Rolf RossaintDepartment of Anesthesiology, University Hospital Aachen, Aachen, Germany.
Mark CoburnDepartment of Anesthesiology, University Hospital Aachen, Aachen, Germany.
Universitätsklinikum Aachen · DEUniversity of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveLike other inhalational anesthetics xenon seems to be associated with post-operative nausea and vomiting (PONV). We assessed nausea incidence following balanced xenon anesthesia compared to sevoflurane, and dexamethasone for its prophylaxis in a randomized controlled trial with post-hoc explorative analysis.

methods220 subjects with elevated PONV risk (Apfel score ≥2) undergoing elective abdominal surgery were randomized to receive xenon or sevoflurane anesthesia and dexamethasone or placebo after written informed consent. 93 subjects in the xenon group and 94 subjects in the sevoflurane group completed the trial. General anesthesia was maintained with 60% xenon or 2.0% sevoflurane. Dexamethasone 4mg or placebo was administered in the first hour. Subjects were analyzed for nausea and vomiting in predefined intervals during a 24h post-anesthesia follow-up.

resultsLogistic regression, controlled for dexamethasone and anesthesia/dexamethasone interaction, showed a significant risk to develop nausea following xenon anesthesia (OR 2.30, 95% CI 1.02-5.19, p = 0.044). Early-onset nausea incidence was 46% after xenon and 35% after sevoflurane anesthesia (p = 0.138). After xenon, nausea occurred significantly earlier (p = 0.014), was more frequent and rated worse in the beginning. Dexamethasone did not markedly reduce nausea occurrence in both groups. Late-onset nausea showed no considerable difference between the groups.

conclusionIn our study setting, xenon anesthesia was associated with an elevated risk to develop nausea in sensitive subjects. Dexamethasone 4mg was not effective preventing nausea in our study. Group size or dosage might have been too small, and change of statistical analysis parameters in the post-hoc evaluation might have further contributed to a limitation of our results. Further trials will be needed to address prophylaxis of xenon-induced nausea.

trial registrationEU Clinical Trials EudraCT-2008-004132-20 ClinicalTrials.gov NCT00793663.

Indexed as

AdolescentAdultAgedAnesthetics, InhalationFemaleHumansMaleMethyl EthersMiddle AgedNauseaSevofluraneVomitingXenonYoung AdultAnesthetics, InhalationMethyl EthersSevofluraneXenon

Identifiers

PMID27111335
PMCPMC4844115
OpenAlexW2342731798

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.