• BeheraBikram KishoreBKFrom 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., Satyajeet Misra, Manoj Kumar Mohanty, and Anand Srinivasan.
• 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.

BackgroundAdministration 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.ObjectivesThe primary objective of this study was to evaluate the effect of 80% FiO2 on the incidence of PONV in children undergoing surgery.DesignProspective, randomised, study.SettingSingle-centre, teaching hospital.PatientsChildren 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.InterventionsAfter induction of anaesthesia, children were randomised to receive either 30 or 80% oxygen in air, till the end of surgery.Main Outcome MeasuresIncidence 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.ResultsThe 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.ConclusionHigh intra-operative FiO2 of 80% does not provide additional protection against PONV in children.Trial RegistrationThe study was registered with Clinical Trials Registry of India (CTRI) with trial registration no: CTRI/2018/07/014974.Copyright © 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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