{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:55:31Z","timestamp":1781744131422,"version":"3.54.5"},"reference-count":20,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Among patients who underwent general anesthesia (GA) multiple times with different methods, we aimed to compare the incidence and severity of postoperative nausea and vomiting (PONV) when the GA method was changed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Subjects were healthy intellectually disabled patients who underwent multiple dental procedures under GA. Methods of general anesthesia were classified as (1) nitrous oxide-sevoflurane (NOS), (2) sevoflurane-remifentanil (SRF), and (3) propofol-remifentanil (PRF). Patients who experienced PONV had an alternative method of GA utilized for subsequent cases. PONV incident rates and severity scores overall and between groups were calculated and compared statistically for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PONV occurred in 186 (6.5%) of the 2872 cases and in 85 (28.8%) of the 295 patients included in this study. Statistical paired comparisons of the mean incidence of PONV demonstrated a decrease of 25.2% when the GA method was changed from NOS to SRF, 40.4% when changed from NOS to PRF, and 36.4% when changed from SRF to PRF (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). Statistical paired comparisons of the mean 5-point PONV severity score similarly demonstrated a decrease of 0.53 when the GA method was changed from NOS to SRF, 0.92 when changed from NOS to PRF, and 0.62 when changed from SRF to PRF (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The highest PONV incidence rates and severity were noted with NOS, whereas PONV decreased significantly with SRF and PRF use. The absence of nitrous oxide and use of propofol were suggested as ways to alter the method of general anesthesia to reduce the incidence and improve the severity of PONV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2344\/25-0003","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:30:49Z","timestamp":1781742649000},"page":"71-76","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Changing the General Anesthesia Method on Postoperative Nausea and Vomiting Incident and Severity"],"prefix":"10.2344","volume":"73","author":[{"given":"Rina","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshito","family":"Ohyama","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hikaru","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Kawaai","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"issue":"4","key":"i1878-7177-73-2-71-b01","series-title":"Clin Plast Surg","first-page":"503","article-title":"Complications of general anesthesia","volume":"40","author":"Harris","year":"2013","unstructured":"Harris M,\nChung F. Complications of general anesthesia. Clin Plast Surg. 2013;40(4):503\u2013513. doi:10.1016\/j.cps.2013.07.001"},{"issue":"3","key":"i1878-7177-73-2-71-b02","series-title":"Anesthesiology","first-page":"693","article-title":"A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers","volume":"91","author":"Apfel","year":"1999","unstructured":"Apfel CC,\nL\u00e4\u00e4r\u00e4 E,\nKoivuranta M,\nGreim CA,\nRoewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91(3):693\u2013700. doi:10.1097\/00000542-199909000-00022"},{"issue":"10","key":"i1878-7177-73-2-71-b03","series-title":"Cochrane Database Syst Rev","first-page":"CD012859","article-title":"Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis","volume":"10","author":"Weibel","year":"2020","unstructured":"Weibel S,\nR\u00fccker G,\nEberhart LH, et al. Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis. Cochrane Database Syst Rev. 2020;10(10):CD012859. doi:10.1002\/14651858.CD012859.pub2"},{"issue":"6","key":"i1878-7177-73-2-71-b04","series-title":"Curr Med Res Opin","first-page":"1093","article-title":"Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis","volume":"22","author":"Habib","year":"2006","unstructured":"Habib AS,\nChen YT,\nTaguchi A,\nHu XH,\nGan TJ. Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis. Curr Med Res Opin. 2006;22(6):1093\u20131099. doi: 10.1185\/030079906X104830"},{"issue":"2","key":"i1878-7177-73-2-71-b05","series-title":"Anesth Analg","first-page":"411","article-title":"Fourth consensus guidelines for the management of postoperative nausea and vomiting","volume":"131","author":"Gan","year":"2020","unstructured":"Gan TJ,\nBelani KG,\nBergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131(2):411\u2013448. doi:10.1213\/ANE.0000000000004833"},{"issue":"2","key":"i1878-7177-73-2-71-b06","series-title":"Anesthesiology","first-page":"221","article-title":"Avoidance of nitrous oxide for patients undergoing major surgery: a randomized controlled trial","volume":"107","author":"Myles","year":"2007","unstructured":"Myles PS,\nLeslie K,\nChan MT V, et al. Avoidance of nitrous oxide for patients undergoing major surgery: a randomized controlled trial. Anesthesiology. 2007;107(2):221\u2013231. doi:10.1097\/01.anes.0000270723.30772.da"},{"issue":"5","key":"i1878-7177-73-2-71-b07","series-title":"Anesthesiology","first-page":"1055","article-title":"Omission of nitrous oxide during anesthesia reduces the incidence of postoperative nausea and vomiting. A meta-analysis","volume":"85","author":"Divatia","year":"1996","unstructured":"Divatia JV,\nVaidya JS,\nBadwe RA,\nHawaldar RW. Omission of nitrous oxide during anesthesia reduces the incidence of postoperative nausea and vomiting. A meta-analysis. Anesthesiology. 1996;85(5):1055\u20131062. doi:10.1097\/00000542-199611000-00014"},{"key":"i1878-7177-73-2-71-b08","series-title":"Anesthesiology","first-page":"162","article-title":"Postoperative nausea and vomiting: its etiology, treatment, and prevention","volume":"77","author":"Watcha","year":"1992","unstructured":"Watcha MF,\nWhite PF: Postoperative nausea and vomiting: its etiology, treatment, and prevention. Anesthesiology. 1992;77:162\u2013184. doi:10.1097\/00000542-199207000-00023"},{"issue":"4","key":"i1878-7177-73-2-71-b09","series-title":"Acta Anaesthesiol Scand","first-page":"447","article-title":"Effects of propofol on ipecacuanha-induced nausea and vomiting","volume":"42","author":"Hammas","year":"2008","unstructured":"Hammas B,\nHvarfner A,\nTh\u00f6rn SE,\nWattwil M. Effects of propofol on ipecacuanha-induced nausea and vomiting. Acta Anaesthesiol Scand. 2008;42(4):447\u2013451. doi:10.1111\/j.1399-6576.1998.tb05140.x"},{"issue":"10","key":"i1878-7177-73-2-71-b10","series-title":"Eur J Anaesthesiol","first-page":"750","article-title":"Total intravenous anaesthesia versus single-drug pharmacological antiemetic prophylaxis in adults: a systematic review and meta-analysis","volume":"33","author":"Schaefer","year":"2016","unstructured":"Schaefer MS,\nKranke P,\nWeibel S,\nKreysing R,\nKienbaum P. Total intravenous anaesthesia versus single-drug pharmacological antiemetic prophylaxis in adults: a systematic review and meta-analysis. Eur J Anaesthesiol. 2016;33(10):750\u2013760. doi:10.1097\/EJA.0000000000000520"},{"issue":"4","key":"i1878-7177-73-2-71-b01","series-title":"Clin Plast Surg","first-page":"503","article-title":"Complications of general anesthesia","volume":"40","author":"Harris","year":"2013","unstructured":"Harris M,\nChung F. Complications of general anesthesia. Clin Plast Surg. 2013;40(4):503\u2013513. doi:10.1016\/j.cps.2013.07.001"},{"issue":"3","key":"i1878-7177-73-2-71-b02","series-title":"Anesthesiology","first-page":"693","article-title":"A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers","volume":"91","author":"Apfel","year":"1999","unstructured":"Apfel CC,\nL\u00e4\u00e4r\u00e4 E,\nKoivuranta M,\nGreim CA,\nRoewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91(3):693\u2013700. doi:10.1097\/00000542-199909000-00022"},{"issue":"10","key":"i1878-7177-73-2-71-b03","series-title":"Cochrane Database Syst Rev","first-page":"CD012859","article-title":"Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis","volume":"10","author":"Weibel","year":"2020","unstructured":"Weibel S,\nR\u00fccker G,\nEberhart LH, et al. Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis. Cochrane Database Syst Rev. 2020;10(10):CD012859. doi:10.1002\/14651858.CD012859.pub2"},{"issue":"6","key":"i1878-7177-73-2-71-b04","series-title":"Curr Med Res Opin","first-page":"1093","article-title":"Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis","volume":"22","author":"Habib","year":"2006","unstructured":"Habib AS,\nChen YT,\nTaguchi A,\nHu XH,\nGan TJ. Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis. Curr Med Res Opin. 2006;22(6):1093\u20131099. doi: 10.1185\/030079906X104830"},{"issue":"2","key":"i1878-7177-73-2-71-b05","series-title":"Anesth Analg","first-page":"411","article-title":"Fourth consensus guidelines for the management of postoperative nausea and vomiting","volume":"131","author":"Gan","year":"2020","unstructured":"Gan TJ,\nBelani KG,\nBergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131(2):411\u2013448. doi:10.1213\/ANE.0000000000004833"},{"issue":"2","key":"i1878-7177-73-2-71-b06","series-title":"Anesthesiology","first-page":"221","article-title":"Avoidance of nitrous oxide for patients undergoing major surgery: a randomized controlled trial","volume":"107","author":"Myles","year":"2007","unstructured":"Myles PS,\nLeslie K,\nChan MT V, et al. Avoidance of nitrous oxide for patients undergoing major surgery: a randomized controlled trial. Anesthesiology. 2007;107(2):221\u2013231. doi:10.1097\/01.anes.0000270723.30772.da"},{"issue":"5","key":"i1878-7177-73-2-71-b07","series-title":"Anesthesiology","first-page":"1055","article-title":"Omission of nitrous oxide during anesthesia reduces the incidence of postoperative nausea and vomiting. A meta-analysis","volume":"85","author":"Divatia","year":"1996","unstructured":"Divatia JV,\nVaidya JS,\nBadwe RA,\nHawaldar RW. Omission of nitrous oxide during anesthesia reduces the incidence of postoperative nausea and vomiting. A meta-analysis. Anesthesiology. 1996;85(5):1055\u20131062. doi:10.1097\/00000542-199611000-00014"},{"key":"i1878-7177-73-2-71-b08","series-title":"Anesthesiology","first-page":"162","article-title":"Postoperative nausea and vomiting: its etiology, treatment, and prevention","volume":"77","author":"Watcha","year":"1992","unstructured":"Watcha MF,\nWhite PF: Postoperative nausea and vomiting: its etiology, treatment, and prevention. Anesthesiology. 1992;77:162\u2013184. doi:10.1097\/00000542-199207000-00023"},{"issue":"4","key":"i1878-7177-73-2-71-b09","series-title":"Acta Anaesthesiol Scand","first-page":"447","article-title":"Effects of propofol on ipecacuanha-induced nausea and vomiting","volume":"42","author":"Hammas","year":"2008","unstructured":"Hammas B,\nHvarfner A,\nTh\u00f6rn SE,\nWattwil M. Effects of propofol on ipecacuanha-induced nausea and vomiting. Acta Anaesthesiol Scand. 2008;42(4):447\u2013451. doi:10.1111\/j.1399-6576.1998.tb05140.x"},{"issue":"10","key":"i1878-7177-73-2-71-b10","series-title":"Eur J Anaesthesiol","first-page":"750","article-title":"Total intravenous anaesthesia versus single-drug pharmacological antiemetic prophylaxis in adults: a systematic review and meta-analysis","volume":"33","author":"Schaefer","year":"2016","unstructured":"Schaefer MS,\nKranke P,\nWeibel S,\nKreysing R,\nKienbaum P. Total intravenous anaesthesia versus single-drug pharmacological antiemetic prophylaxis in adults: a systematic review and meta-analysis. Eur J Anaesthesiol. 2016;33(10):750\u2013760. doi:10.1097\/EJA.0000000000000520"}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/73\/2\/article-p71.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/73\/2\/article-p71.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/73\/2\/article-p71.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:30:52Z","timestamp":1781742652000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/73\/2\/article-p71.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":20,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.2344\/25-0003","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"value":"1878-7177","type":"electronic"},{"value":"0003-3006","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}