The Incidence of Postoperative Nausea and Vomiting after Thyroidectomy using Three Anaesthetic Techniques

Abstract

Introduction: The choice of anaesthetics can affect the incidence of postoperative nausea and vomiting (PONV). This study compared the incidence of PONV in female patients who underwent thyroidectomy with anaesthesia induced by sevoflurane, propofol？ remifenanil or sevoflurane？propofol？remifentanil.

Methods: 177 female patients who underwent thyroidectomy were randomly allocated to three groups. Each patient was induced and maintained using one of three regimens: (i) sevoflurane (thiopental sodium 4 ？ 5 mg/kg and sevoflurane 2.0 ？ 2.5 vol% in 50% air); (ii) total intravenous anaesthesia (TIVA; propofol？remifentanil [target blood concentrations 2.5 ？ 3.5 ？g/ml and 3.5 ？ 4.5 ng/ml, respectively]); or (iii) combined inhalation and intravenous anaesthesia (sevoflurane 1.0 vol% in 50% air plus propofol？remifentanil [target blood concentrations 1.5 ？ 2.5 ？g/ml and 2.5 ？ 3.5 ng/ml, respectively]) The incidence and severity of PONV and the need for rescue antiemetics were assessed at 0 ？ 24 h postoperatively.

Results: The overall incidence of PONV was significantly lower in the TIVA and combined groups compared with the sevoflurane group (33.9%, 39.0% and 64.4%, respectively).

Conclusion: The maintenance of anesthesia with propofol？remifentanil or sevoflurane？propofol？remifentanil decreased the incidence of PONV compared with sevoflurane alone.