{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:51:52Z","timestamp":1790103112631,"version":"4.0.1"},"reference-count":52,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T00:00:00Z","timestamp":1631664000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007771","name":"\u015al\u0105ski Uniwersytet Medyczny","doi-asserted-by":"publisher","award":["KNW-1-183\/N\/9\/K"],"award-info":[{"award-number":["KNW-1-183\/N\/9\/K"]}],"id":[{"id":"10.13039\/100007771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The intraprocedural immobilization of selected subsets of patients undergoing pars plana vitrectomy (PPV) requires the performance of general anesthesia (GA), which entails the intraoperative use of hypnotics and titration of opioids. The Adequacy of Anesthesia (AoA) concept of GA guidance optimizes the intraoperative dosage of hypnotics and opioids. Pre-emptive analgesia (PA) is added to GA to minimize intraoperative opioid (IO) usage. The current additional analysis evaluated the advantages of PA using either COX-3 inhibitors or regional techniques when added to AoA-guided GA on the rate of presence of postoperative nausea and vomiting (PONV), oculo-emetic (OER), and oculo-cardiac reflex (OCR) in patients undergoing PPV. A total of 176 patients undergoing PPV were randomly allocated into 5 groups: (1) Group GA, including patients who received general anesthesia alone; (2) Group T, including patients who received preventive topical analgesia by triple instillation of 2% proparacaine 15 min before induction of GA; (3) Group PBB, including patients who received PBB; (4) Group M, including patients who received PA using a single dose of 1 g of metamizole; (5) Group P, including patients who received PA using a single dose of 1 g of acetaminophen. The incidence rates of PONV, OCR, and OER were studied as a secondary outcome. Despite the group allocation, intraoperative AoA-guided GA resulted in an overall incidence of PONV in 9%, OCR in 12%, and OER in none of the patients. No statistically significant differences were found between groups regarding the incidence of OCR. PA using COX-3 inhibitors, as compared to that of the T group, resulted in less overall PONV (p &lt; 0.05). Conclusions: PA using regional techniques in patients undergoing PPV proved to have no advantage when AoA-guided GA was utilised. We recommend using intraoperative AoA-guided GA to reduce the presence of OCR, and the addition of PA using COX-3 inhibitors to reduce the rate of PONV.<\/jats:p>","DOI":"10.3390\/jcm10184172","type":"journal-article","created":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T12:00:44Z","timestamp":1631707244000},"page":"4172","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Adverse Events during Vitrectomy under Adequacy of Anesthesia\u2014An Additional Report"],"prefix":"10.3390","volume":"10","author":[{"given":"Aleksandra","family":"Pluta","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-200 Sosnowiec, Poland"},{"name":"Department of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3507-4942","authenticated-orcid":false,"given":"Micha\u0142 Jan","family":"Stasiowski","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-200 Sosnowiec, Poland"},{"name":"Department of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4405-8020","authenticated-orcid":false,"given":"Anita","family":"Lyssek-Boro\u0144","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology with Paediatric Unit, 5th Regional Hospital, 41-200 Sosnowiec, Poland"},{"name":"Department of Ophthalmology, Faculty of Medicine in Zabrze, University of Technology in Katowice, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6828-5538","authenticated-orcid":false,"given":"Seweryn","family":"Kr\u00f3l","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, 41-200 Sosnowiec, Poland"},{"name":"Department of General, Colorectal and Polytrauma Surgery, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-555 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lech","family":"Krawczyk","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-200 Sosnowiec, Poland"},{"name":"Department of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0612-1949","authenticated-orcid":false,"given":"Ewa","family":"Niewiadomska","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health in Bytom, Medical University of Silesia, 41-902 Bytom, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"\u017bak","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-200 Sosnowiec, Poland"},{"name":"Department of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Kawka","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology with Paediatric Unit, 5th Regional Hospital, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8768-1691","authenticated-orcid":false,"given":"Dariusz","family":"Dobrowolski","sequence":"additional","affiliation":[{"name":"Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1633-7145","authenticated-orcid":false,"given":"Beniamin Oskar","family":"Grabarek","sequence":"additional","affiliation":[{"name":"Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, University of Technology in Katowice, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izabela","family":"Szumera","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-200 Sosnowiec, Poland"},{"name":"Department of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Missir","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, 5th Regional Hospital, 41-200 Sosnowiec, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Rejdak","sequence":"additional","affiliation":[{"name":"Department of General Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2956-7890","authenticated-orcid":false,"given":"Przemys\u0142aw","family":"Ja\u0142owiecki","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-200 Sosnowiec, Poland"},{"name":"Department of 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