This article evaluates whether avoidance of nitrous oxide in general anaesthesia can improve clinical outcomes in surgical patients by reducing postoperative nausea and vomiting, and whether avoidance should become part of a routine clinical management strategy. Despite some controversy, the greatest strength of evidence suggests that avoidance of nitrous oxide may be justified as a pre-emptive perioperative strategy as part of a multimodal approach to postoperative nausea and vomiting, especially in those patients known to have a higher baseline risk.
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