Aanesthetic Agents for Day Surgery - NIHR Health Technology ...

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Results of the paediatric economic evaluation
given in Table 46. All 322 patients were anaesthetised
by physician anaesthetists. Within this,
12 consultant anaesthetists carried out 280 procedures
and eight non-consultant anaesthetists
carried out 42 procedures. The 322 patients
were treated by eight surgeons.
Of 322 paediatric study participants’ parents/
guardians, 251 (78.0%) were married, 36 (11.2%)
were separated, 31 (9.6%) were single, two were
widowed and two did not answer. Employment
details were recorded and categorised into social
class for all male parents (employed and retired)
of participants. In the case of single women, their
own social class was recorded (Table 47).
TABLE 47 The social class of the participants in the
paediatric study
Social class No. of British value
patients (%) 248
I 11 (3%) 5
II 53 (16%) 16
IIIN 43 (13%) 35
IIIM 42 (13%) 19
IV 48 (14%) 18
V 9 (2%) 6
Unemployed,
student, housewife
116 (36%) Not given
Clinical outcome data
PONV by anaesthetic regimen
The incidence of PONV was analysed to assess
whether the risk of PONV differed between
the anaesthetic regimens. First, the crude
(unadjusted) figures were tabulated. Further
tables in appendix 29 display the association
between PONV and other variables that plausibly
might be associated with risk. Logistic regression
analysis was employed to confirm the impression
portrayed by the tabular analyses. It was also used
to adjust the estimates of PONV risk in order to
allow for any residual effects of the potential
confounding variables arising from them not
being exactly evenly distributed across the randomisation
arms. The total numbers of subjects shown
in the tables vary slightly, since there are missing
data for some of the variables. Probability values
presented with tables refer, unless otherwise
stated, to a simple test for heterogeneity among
categories. So-called ‘exact’ tests were employed
when appropriate. Probability values are not
presented for tables examining the distribution
of potential confounding variables among the
randomisation categories, as the statistical significance
of observed differences is not relevant to
the question of confounding.
The randomisation of children occurred within
two strata defined by gender. Table 48 displays
the occurrence of PONV by anaesthetic regimen
within each of the gender strata. It is apparent
that within each stratum the risk of occurrence
of PONV was greatest under the sevoflurane/
sevoflurane regimen.
Tables 49 to 51 display the occurrence of
PONV by severity in the two anaesthesia categories.
The occurrence of PONV is greater in
the sevoflurane/sevoflurane group (ORs,
compared to propofol/halothane, of 2.9 and
4.1 for ‘nausea or vomiting’ and ‘one or more
episodes of vomiting’ respectively). Two or more
episodes of vomiting were too infrequent to
bear separate analysis.
Other adverse events
Table 52 summarises the degree of orientation
of patients during recovery from the anaesthesia.
There was a statistically significant difference in
the degree of orientation between the two
anaesthetic regimens.
TABLE 48 The occurrence of PONV by anaesthetic regimen in the two predefined strata in the paediatric study
Stratum PONV Anaesthetic regimen Total
Sevoflurane/sevoflurane Propofol/halothane
Male No 96 (83.5%) 101 (94.4%) 197 (88.7%)
Yes 19 (16.5%) 6 (5.6%) 25 (11.3%)
Total 115 (100.0%) 107 (100.0%) 222 (100.0%)
Female No 43 (89.6%) 49 (94.2%) 92 (92.0%)
Yes 5 (10.4%) 3 (5.8%) 8 (8.0%)
Total 48 (100.0%) 52 (100.0%) 100 (100.0%)