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

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.