The effect of BIS-guided anaesthesia on the incidence of postoperative nausea and vomiting in children: a prospective randomized double-blind study

BMC Anesthesiol. 2024 Jul 9;24(1):228. doi: 10.1186/s12871-024-02610-w.

Abstract

Background: Postoperative nausea and vomiting (PONV) is a significant problem following paediatric surgery, and volatile anaesthetics are an important cause of this phenomenon. BIS-guided anaesthesia, by reducing the consumption of anaesthetics, leads to a decrease in PONV in adult patients.

Study objective: Evaluate the role of BIS-guided anaesthesia in reducing the incidence of paediatric PONV.

Design: Prospective, randomized, double-blind study.

Setting: A single center study in university hospital in Czech republic, from June 2021 to November 2022.

Patients: A total of 163 children, aged 3-8 years with ASA I-II who underwent endoscopic adenoidectomy under general anaesthesia were included.

Interventions: In the intervention group, the depth of anaesthesia was maintained to values between 40 and 60 of BIS.

Main outcome measure: The primary outcome was the incidence of postoperative nausea and vomiting during 24 h after surgery.

Results: The use of BIS-guided anaesthesia led to a significant decrease in the incidence of nausea and vomiting compared to the control group [17% vs. 53%; RR (95%CI) 0.48 (0.27-0.86); p < 0.001and 16% vs. 34%; RR (95%CI) 0.33 (0.20-0.54); p = 0.01, respectively].

Conclusions: BIS-guided anaesthesia decreases the incidence of postoperative nausea and vomiting in children undergoing adenoidectomy.

Trial registration: Clinicaltrials.gov identifier: NCT04466579.

Keywords: BIS monitoring; Children; Postoperative nausea and vomiting; Postoperative pain.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoidectomy* / adverse effects
  • Adenoidectomy* / methods
  • Anesthesia, General* / adverse effects
  • Anesthesia, General* / methods
  • Child
  • Child, Preschool
  • Czech Republic / epidemiology
  • Double-Blind Method
  • Female
  • Humans
  • Incidence
  • Male
  • Postoperative Nausea and Vomiting* / epidemiology
  • Postoperative Nausea and Vomiting* / prevention & control
  • Prospective Studies

Associated data

  • ClinicalTrials.gov/NCT04466579