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

Abstract

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