From the Department of Anesthesiology & Critical Care (BKB, SM), Department of Pediatric Surgery (MKM) and Department of Pharmacology (AS), All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Orissa, India.
Eur J Anaesthesiol. 2021 Nov 1;38(11):1124-1129. doi: 10.1097/EJA.0000000000001577.
Administration of high inspired fraction of oxygen (FiO2) during anaesthesia has been proposed to decrease postoperative nausea and vomiting (PONV) in adults but has not been extensively studied in children.
The primary objective of this study was to evaluate the effect of 80% FiO2 on the incidence of PONV in children undergoing surgery.
Prospective, randomised, study.
Single-centre, teaching hospital.
Children of either gender in the age group of 5 to 15 years scheduled for elective surgeries were assessed for eligibility. Emergency surgeries; patients receiving supplemental oxygen pre-operatively or on mechanical ventilation; sepsis; bowel obstruction or ischaemia; poor nutritional status; anaemia (Hb <8 g%) or surgeries lasting less than 1 h or greater than 4 h were excluded from the study.
After induction of anaesthesia, children were randomised to receive either 30 or 80% oxygen in air, till the end of surgery.
Incidence of PONV within 24 h; surgical site infections (SSI)s; serum serotonin and TNF-α levels and the incidence of postoperative pulmonary complications (PPC)s were studied.
The overall 24 h incidence of PONV was not different between the low and high FiO2 groups [24 vs. 23%; P = 0.84; odds ratio (OR) 0.92; 95% confidence interval (CI), 0.44 to 2.06]. The incidence of SSIs (15 vs. 12%; P = 0.61; OR 0.77; 95% CI, 0.28 to 2.10) and PPCs (12 vs. 8%; P = 0.38; OR 0.59; 95% CI, 0.18 to 1.92) were not significant between the low and high FiO2 groups, respectively. Intragroup and intergroup comparisons of serum serotonin and TNF-α showed no significant difference either at baseline or at the end of surgery.
High intra-operative FiO2 of 80% does not provide additional protection against PONV in children.
The study was registered with Clinical Trials Registry of India (CTRI) with trial registration no: CTRI/2018/07/014974.
在麻醉期间给予高吸入氧分数（FiO2）已被提议用于减少成人术后恶心和呕吐（PONV），但在儿童中尚未广泛研究。
本研究的主要目的是评估 80%FiO2 对接受手术的儿童 PONV 发生率的影响。
前瞻性、随机研究。
单中心、教学医院。
年龄在 5 至 15 岁的接受择期手术的男女儿童均进行了资格评估。急诊手术；术前或机械通气时接受补充氧气的患者；脓毒症；肠梗阻或缺血；营养状况差；贫血（Hb<8g%）或手术时间少于 1 小时或超过 4 小时的患者被排除在研究之外。
麻醉诱导后，儿童随机接受 30%或 80%空气中的氧气，直至手术结束。
24 小时内 PONV 的发生率；手术部位感染（SSI）；血清 5-羟色胺和 TNF-α水平以及术后肺部并发症（PPC）的发生率。
低 FiO2 和高 FiO2 组 24 小时内 PONV 的总发生率无差异[24%与 23%；P=0.84；优势比（OR）0.92；95%置信区间（CI）0.44 至 2.06]。SSI 的发生率（15%与 12%；P=0.61；OR 0.77；95%CI，0.28 至 2.10）和 PPC 的发生率（12%与 8%；P=0.38；OR 0.59；95%CI，0.18 至 1.92）在低 FiO2 和高 FiO2 组之间均无显著差异。血清 5-羟色胺和 TNF-α 的组内和组间比较在基线或手术结束时均无显著差异。
术中高 FiO2 80%不能为儿童提供额外的 PONV 保护。
该研究在印度临床试验注册处（CTRI）注册，试验注册号：CTRI/2018/07/014974。
