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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Julien Sansonnens, Patrick Taffé, Bernard Burnand, for the ADS study group

Published in: BMC Anesthesiology | Issue 1/2015

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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.
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Metadata
Title
Higher occurrence of nausea and vomiting after total hip arthroplasty using general versus spinal anesthesia: an observational study
Authors
Julien Sansonnens
Patrick Taffé
Bernard Burnand
for the ADS study group
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2015
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-016-0207-0

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