Higher occurrence of nausea and vomiting after total hip arthroplasty using general versus spinal anesthesia: an observational study.

TitreHigher occurrence of nausea and vomiting after total hip arthroplasty using general versus spinal anesthesia: an observational study.
Publication TypeJournal Article
Year of Publication2016
AuthorsSansonnens, J, Taffé, P, Burnand, B
Corporate AuthorsADS study Group
JournalBMC Anesthesiol
Volume16
Issue1
Pagination44
Date Published2016
DOI10.1186/s12871-016-0207-0
ISSN1471-2253
Abstract

BACKGROUND: Under the assumption that postoperative nausea and vomiting (PONV) may occur after total hip arthroplasty (THA) regardless of the anesthetic technique used, it is not clear whether general (GA) or spinal (SA) anesthesia has higher causal effect on this occurrence. Conflicting results have been reported.

METHODS: In this observational study, we selected all elective THA interventions performed in adults between 1999 and 2008 in a Swiss orthopedic clinic under general or spinal anesthesia. To assess the effect of anesthesia type on the occurrence of PONV, we used the propensity score and matching methods, which allowed us to emulate the design and results of an RCT.

RESULTS: Among 3922 procedures, 1984 (51 %) patients underwent GA, of which 4.1 % experienced PONV, and 1938 underwent SA, of which 3.5 % experienced PONV. We found that the average treatment effect on the treated, i.e. the effect of anesthesia type for a sample of individuals that actually received spinal anesthesia compared to individuals who received GA, was ATET = 2.00 % [95 % CI, 0.78-3.19 %], which translated into an OR = 1.97 [95 % CI 1.35; 2.87].

CONCLUSION: This suggests that the type of anesthesia is not neutral regarding PONV, general anesthesia being more strongly associated with PONV than spinal anesthesia in orthopedic surgery.

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/27459997?dopt=Abstract

Alternate JournalBMC Anesthesiol
Citation Key / SERVAL ID7156
PubMed ID27459997
PubMed Central IDPMC4962505

                         

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