Faculty Opinions recommendation of Effect of intraoperative high inspired oxygen fraction on surgical site infection, postoperative nausea and vomiting, and pulmonary function: systematic review and meta-analysis of randomized controlled trials.

Abstract Objectives This meta-analysis aimed to evaluate the efficacy and safety of antimuscarinics for the prevention or treatment of catheter related bladder discomfort (CRBD). Methods The MEDLINE, EMBASE, and Cochrane Controlled Trials Register (from 1987 to July 2021) were used to search randomized controlled trials. The PRISMA checklists were followed. RevMan5.4.0 was used for statistical analysis. Results Eleven studies involving 1165 patients were involved in the analysis. The study reported that the incidence of CRBD observed in the antimuscarinics group was significantly lower than that of the control group at 0-, 1-, 2-, and 6-h after drug therapy (P = 0.001, P < 0.0001, P = 0.0005, and P = 0.001, respectively). For side effects, there were not statistical differences between the antimuscarinics group and the control group, mainly including dry mouth (risk ratio (RR) = 1.31, 95% confidence interval (CI) = 0.95 to 1.80, P = 0.09), postoperative nausea and vomiting (RR = 1.02, 95% CI = 0.55 to 1.90, P = 0.87), facial flushing (RR = 1.06, 95% CI = 0.43 to 2.61, P = 0.90), and blurred vision (RR = 0.95, 95% CI = 0.35 to 2.58, P = 0.91). Besides, rescue analgesics were required less in the antimuscarinics group than in the control group (RR = 0.51, 95% CI = 0.32 to 0.80, P = 0.003). Conclusions Compared with the control group, the antimuscarinics group had a significant improvement on CRBD, the patients were well tolerated and the use rate of rescue analgesics was low.

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Comment on: "Effects of high versus low inspiratory oxygen fraction on postoperative clinical outcomes in patients undergoing surgery under general anesthesia: A systematic review and meta-analysis of randomized controlled trials"

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2021.110644 ◽

2022 ◽

Vol 77 ◽

pp. 110644

Author(s):

Ahmed M. Hasanin ◽

Kareman M. Abdelghafar ◽

Mohamed Abdulatif

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

General Anesthesia ◽

Clinical Outcomes ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Oxygen Fraction ◽

Inspiratory Oxygen

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Omission of Nitrous Oxide during Anesthesia Reduces the Incidence of Postoperative Nausea and Vomiting

Anesthesiology ◽

10.1097/00000542-199611000-00014 ◽

1996 ◽

Vol 85 (5) ◽

pp. 1055-1062 ◽

Cited By ~ 139

Author(s):

Jigeeshu V. Divatia ◽

Jayant S. Vaidya ◽

Rajendra A. Badwe ◽

Rohini W. Hawaldar

Keyword(s):

Nitrous Oxide ◽

Subgroup Analysis ◽

Postoperative Nausea ◽

Odds Ratio ◽

Meta Analysis ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Controlled Trials ◽

Maximal Effect ◽

Randomized Controlled

Background Postoperative nausea and vomiting are important causes of morbidity after general anesthesia. Nitrous oxide has been implicated as an emetogenic agent in many studies. However, several other trials have failed to sustain this claim. The authors tried to resolve this issue through a meta-analysis of randomized controlled trials comparing the incidence of postoperative nausea and vomiting after anesthesia with or without nitrous oxide. Methods Of 37 published studies retrieved by a search of articles indexed on the MEDLINE database from 1966 to 1994, 24 studies (26 trials) with distinct nitrous-oxide and non-nitrous oxide groups were eligible for the meta-analysis. The pooled odds ratio and relative risk were calculated. Post boc subgroup analysis was also performed to qualify the result. Results The pooled odds ratio was 0.63 (0.53 to 0.75). Omission of nitrous oxide reduced the risk for postoperative nausea and vomiting by 28% (18% to 37%). In the subgroup analysis, the maximal effect of omission of nitrous oxide was seen in female patients. In patients undergoing abdominal surgery and general surgical procedures, the effect of omission of nitrous oxide, although in the same direction, was not significant. Conclusion Omission of nitrous oxide reduced the odds of postoperative nausea and vomiting by 37%, a reduction in risk of 28%.

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