Anesth Pain Med.  2010 Jan;5(1):45-49.

The effect of multimodal approach with combination of antiemetics and total intravenous anesthesia on postoperative nausea and vomiting in very high-risk patients

• Hwang HY
• Kim EJ
• Yang MK
• Kim JA
• Kang JG
• Kim TH
• Song HW

Abstract

BACKGROUND: Postoperative nausea and vomiting (PONV) is a long standing problem in both surgical patients and anesthesiologists, and the treatment of this problem is very important.The purpose of this study was to evaluate the effect of multimodal approach with combination of antiemetics and total intravenous anesthesia (TIVA) on PONV in very high risk patients identified by the Korean predictive model.
METHODS
Between March 2008 and February 2009, we evaluated 96 patients who were considered to be at very high risk of PONV according to the Korean predictive model.Among the patients, those who received antiemetic combination of dexamethasone and ondansetron were allocated to treatment group (T) and, those who underwent operation without antiemetics were placed in control group (C).All patients were anesthetized using propofol and remifentanil.We evaluated the incidences of PONV in two groups during the first 24 hours after surgery.
RESULTS
The overall incidence of PONV was 14 (29.17%) in C group and 4 (8.33%) in T group, respectively (P = 0.027).
CONCLUSIONS
The overall incidence of PONV in T group was significantly lower than that of C group.This study shows that multimodal approach with combination of antiemetics and TIVA was effective in preventing PONV in patients with very high risk.

Keyword

Antiemetics; Postoperative nausea and vomiting; Total intravenous anesthesia

MeSH Terms

Anesthesia, Intravenous
Antiemetics
Dexamethasone
Humans
Incidence
Ondansetron
Postoperative Nausea and Vomiting
Propofol
Antiemetics
Dexamethasone
Ondansetron
Propofol