Postoperative nausea and vomiting after endoscopic thyroidectomy: total intravenous vs. balanced anesthesia.
10.4097/kjae.2011.60.6.416
- Author:
Gunn Hee KIM
1
;
Hyun Joo AHN
;
Hyun Soo KIM
;
Si Ra BANG
;
Hyun Sung CHO
;
Mikyung YANG
;
Jie Ae KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Endoscopic surgery;
PONV;
Thyroidectomy
- MeSH:
Anesthesia;
Anesthesia, General;
Anesthesia, Intravenous;
Balanced Anesthesia;
Female;
Humans;
Incidence;
Methyl Ethers;
Nausea;
Patient Satisfaction;
Postoperative Nausea and Vomiting;
Postoperative Period;
Thyroidectomy
- From:Korean Journal of Anesthesiology
2011;60(6):416-421
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Endoscopic thyroidectomy was recently introduced and has been rapidly accepted by surgeons and patients. The present study was conducted to estimate and compare the incidences of postoperative nausea and vomiting (PONV) after endoscopic thyroidectomy using two different anesthetic methods: sevoflurane based balanced anesthesia; total intravenous anesthesia (TIVA). METHODS: Ninety nine female patients that were scheduled to undergo elective endoscopic thyroidectomy under general anesthesia were enrolled. These patients were randomly allocated to receive sevoflurane based balanced anesthesia (BA group) or propofol-remifentanil anesthesia (TIVA group). PONV was evaluated using a 4-point Likert scale, and pain using a visual analogue scale (VAS; range 0 to 100) for 0-2, 2-6, and 6-24 hours postoperatively. At 24 hours postoperatively, overall patient satisfaction regarding PONV and pain were recorded. RESULTS: The incidence of PONV was 14.6% in the TIVA group and 51.3% in the BA group. The incidence of nausea at 0-2 and 2-6 hours postoperatively was lower in the TIVA group than in the BA group (4.2% vs. 35.9%, 6.3% vs. 23.1%, respectively), but no between-group difference was observed at 6-24 hours postoperatively (8.3% vs. 5.1%). Antiemetic usage at 0-2 and 2-6 hours was lower in the TIVA than the BA group (4.2% vs. 38.5%, 6.3% vs. 23.1%), but no between-group difference was observed for 6-24 hours (6.3% vs. 7.7%). There were no differences in pain or in patient satisfaction. CONCLUSIONS: After endoscopic thyroidectomy, total intravenous anesthesia with propofol-remifentanil is associated with less PONV during the early postoperative period (0-6 hours) than sevoflurane based balanced anesthesia.
