CClinicalTrials.gg
CompletedNCT07189845Updated Feb 12, 2026

Effect of BIS-Guided Anesthesia on Postoperative Nausea and Vomiting in Pediatric Patients

An interventional study of BIS GROUP and CONTROL GROUP in PONV and BIS, sponsored by Engin Çetin. Completed at 1 site in Turkey (Türkiye). Open to participants aged 3 Years to 8 Years. Per ClinicalTrials.gov, last updated 2026-02-12.

Sponsored by Engin Çetin · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
58
Allocation
Randomized
Ages
3 Years to 8 Years
Sex
All
01

Study summary

This randomized controlled trial will evaluate the effect of bispectral index (BIS)-guided anesthesia on postoperative nausea and vomiting (PONV) in children aged 3-8 years undergoing elective adenoidectomy. Fifty-eight patients will be randomized to BIS-guided anesthesia (target 40-60) or standard clinical management. The primary outcome is PONV incidence within 24 hours. Secondary outcomes include antiemetic use, emergence time, hospital stay, and parental satisfaction.

Read the detailed description

This prospective, randomized, double-blind controlled trial aims to evaluate the effect of bispectral index (BIS)-guided anesthesia on postoperative nausea and vomiting (PONV) in children aged 3 to 8 years undergoing elective adenoidectomy. PONV is a common postoperative complication in pediatric surgery, with reported incidences of 30-70%, leading to delayed oral intake, prolonged hospital stay, and reduced parental satisfaction. BIS monitoring provides an objective EEG-based measure of anesthesia depth, allowing precise titration of anesthetic agents and potentially reducing postoperative complications. While adult studies and meta-analyses have shown that BIS guidance decreases the incidence of PONV, evidence in pediatric populations remains limited. A total of 58 ASA I-II patients will be randomized into two groups: BIS-guided anesthesia (target 40-60) and standard clinical parameter-guided anesthesia with the BIS screen hidden. The primary outcome is the incidence of PONV within 24 hours postoperatively. Secondary outcomes include antiemetic use, severity of PONV, time to emergence, length of hospital stay, and parental satisfaction assessed with a Likert scale. The findings of this trial are expected to clarify the role of BIS monitoring in improving postoperative outcomes in pediatric anesthesia.

02

Conditions studied

  • PONV
  • BIS

Keywords

  • ponv
  • bıs
03

Who can participate

Ages eligible
3 Years to 8 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Children aged 3-8 years
  • ASA physical status class I-II
  • Scheduled for elective adenoidectomy
  • Written informed consent obtained from parents

Exclusion criteria

Exclusion Criteria:

  • Children with a previous history of PONV
  • Patients receiving antiemetic, steroid, or sedative medication
  • Acute upper respiratory tract infection
  • History of neurological or psychiatric disorders
  • Body mass index (BMI) below the 5th percentile or above the 95th percentile
  • Anatomical airway abnormalities
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
58 participants (actual)

Study arms

  • Active comparator
    BIS GROUP

    BIS monitoring will be visible, and anesthesia depth will be adjusted according to BIS values (40-60).

    Diagnostic Test: BIS GROUP

  • Active comparator
    CONTROL GROUP

    In the control group, the BIS monitor will be applied with the screen concealed from the investigator, and anesthesia depth will be guided solely by clinical parameters

    Diagnostic Test: CONTROL GROUP

Interventions

  • Diagnostic testBIS GROUP

    In the BIS group, monitoring will be visible and anesthesia depth will be maintained within a BIS value range of 40-60.

  • Diagnostic testCONTROL GROUP

    In the control group, the BIS monitor will be applied with the screen concealed from the investigator, and anesthesia depth will be guided solely by clinical parameters.

05

What researchers measure

Primary outcomes

  1. Incidence of postoperative nausea and vomiting (PONV) during the first 24 hours postoperatively.

    PONV will be assessed at postoperative intervals of 0-6, 6-12, and 12-24 hours. The Postoperative nausea and vomiting (PONV) will be assessed at postoperative intervals of 0-6, 6-12, and 12-24 hours. PONV severity will be evaluated using a predefined four-point ordinal scale based on the presence and frequency of nausea and vomiting, as follows: 0: No nausea or vomiting 1. Mild nausea 2. Severe nausea or a single vomiting episode 3. Severe nausea with multiple vomiting episodes or intractable PONV

    Time frame: T1: Immediately before extubation T2: 6 hours after extubation T3: 12 hours after extubation T4: 24 hours after extubation

Secondary outcomes

  1. Emergence Time

    Emergence time (defined as the time from discontinuation of sevoflurane until the patient opens their eyes in response to verbal command)

    Time frame: From discontinuation of sevoflurane at the end of surgery until eye opening in response to verbal command, assessed up to 30 minutes

  2. Antiemetic use and timing

    The administration of rescue antiemetic drugs will be recorded for each patient within the first 24 hours after surgery. The specific agent used (e.g., ondansetron, dexamethasone), the time of administration, and the number of doses will be documented from anesthesia and nursing records. The outcome will be expressed as the proportion of patients requiring antiemetic medication and the mean time to first administration

    Time frame: 0-24 hours postoperatively

06

Study locations

1 site
  • University of Health Sciences Kocaeli City Hospital
    Kocaeli, Izmit 41100, Turkey (Türkiye)
07

References and documents

Publications

  • Frelich M, Sklienka P, Romanova T, Nemcova S, Bilena M, Strakova H, Lecbychova K, Jor O, Formanek M, Bursa F. The effect of BIS-guided anaesthesia on the incidence of postoperative nausea and vomiting in children: a prospective randomized double-blind study. BMC Anesthesiol. 2024 Jul 9;24(1):228. doi: 10.1186/s12871-024-02610-w. PubMed 38982400 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT07189845
Lead sponsor
Engin Çetin
Responsible party
Engin Çetin (principal investigator, Kocaeli City Hospital) — Sponsor-investigator
First posted
Sep 24, 2025
Start date
Sep 24, 2025
Primary completion
Jan 20, 2026
Completion
Jan 20, 2026
Last update
Feb 12, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion