Korean J Anesthesiol.  2014 Mar;66(3):216-221. 10.4097/kjae.2014.66.3.216.

Postoperative nausea and vomiting after total thyroidectomy: sevoflurane combined with prophylactic ramosetron vs. propofol-based total intravenous anesthesia

• Park SH
• Lee HG
• Jeong CY
• Jeong SW
• Lee SH
• Kim HJ

• KMID: 2092448
• DOI: http://doi.org/10.4097/kjae.2014.66.3.216

Abstract

BACKGROUND
The frequent and distressing adverse events (AEs) of postoperative nausea and vomiting (PONV) are of major concern in 63-84% of adult patients undergoing thyroidectomy. We conducted this prospective study to compare two prophylactic strategies; sevoflurane combined with ramosetron and propofol-based total intravenous anesthesia in a homogenous group of non-smoking women undergoing total thyroidectomy.
METHODS
In the current prospective study, we enrolled a consecutive series of 64 female patients aged between 20 and 65 years with an American Society of Anesthesiologists physical status of I or II who were scheduled to undergo elective total thyroidectomy under general anesthesia. Patients were randomized to either the SR (sevoflurane and remifentanil) group or the TIVA group. We evaluated the incidence and severity of PONV, the use of rescue anti-emetics and the severity of pain during the first 24 h after surgery.
RESULTS
There were no significant differences in the proportion of the patients with a complete response and the Rhodes index, including the occurrence score, distress score and experience score, between the two groups. In addition, there were no significant differences in the proportion of the patients who were in need of rescue anti-emetics or analgesics and the VAS scores between the two groups.
CONCLUSIONS
In conclusion, TIVA and ramosetron prophylaxis reduced the expected incidence of PONV in women undergoing total thyroidectomy. In addition, there was no significant difference in the efficacy during the first 24 h postoperatively between the two prophylactic regimens.

Keyword

Postoperative nausea and vomiting; Propofol; Ramosetron; Thyroidectomy

MeSH Terms

Adult
Analgesics
Anesthesia, General
Anesthesia, Intravenous*
Antiemetics
Female
Humans
Incidence
Postoperative Nausea and Vomiting*
Propofol
Prospective Studies
Thyroidectomy*
Analgesics
Antiemetics
Propofol