Antiemetic Efficacy of Prophylactic Ondansetron in Gynecologic Patient Using Patient-Controlled Analgesia after Surgery / 대한마취과학회지

BACKGROUND: Postoperative nausea and vomiting remain troublesome problems, especially in women receiving the opioid analgesics. This study was performed to assess the antiemetic efficacy of ondansetron in patients using an intravenous patient-controlled analgesia (IV-PCA) after gynecologic surgery. METHODS: In this randomized placebo-controlled study, forty healthy gynecologic surgical patients received ondansetron 4 mg or placebo at the end of surgery. Patients in the recovery room received fentanyl by PCA which provided a bolus dose of 20 microgram, a lockout time of 6 minutes, and a basal infusion of 20 microgram/hr. We assessed the occurrence of nausea, vomiting, and the need for rescue antiemetics during the first 24 hours after operation. RESULTS: During the first 24 hr after operation, 40% of patients experienced no nausea or vomiting in the ondansetron group compared to 30% of patients in the placebo group. There was no significant difference in the incidence of nausea between groups (70% in placebo group vs 60% in ondansetron group). However, ondansetron reduced the incidence of vomiting from 50% to 15%, and the need for rescue antiemetics significantly from 25% to 0% (P< 0.05). CONCLUSIONS: Ondansetron in a dose of 4 mg does not prevent postoperative nausea during the first 24 hours after operation when used with fetanyl PCA. However, ondansetron significantly reduces the chance of postoperative vomiting and rescue antiemetics.

Effect of Propofol on the Incidence of Postoperative Nausea and Vomiting after Minor Orthopedic Surgery / 대한마취과학회지

BACKGROUND: The aim of the present study is to evaluate the effect of propofol on the incidence of postoperative nausea and vomiting (PONV) during the first 24 hours after minor orthopedic surgery using general anesthesia. METHODS: We studied 66 healthy female patients (aged 20-67 years old). The patients were randomly divided into the two groups: (i) Group P (n=33): Anesthesia was induced with propofol and fentanyl, and maintained with continuous infusion of propofol. (ii) Group E (n=33): Anesthesia was induced with thiopental and fentanyl, and maintained with enflurane. We compared the incidence and severity of PONV at 6 and 24 hours after the operation between the two groups. RESULTS: The incidence and severity of PONV in Group P was significantly lower than in Group E during the first 6 hours after the operation (p<0.05). However, after 6 hours, there was no significant differences between the two groups. CONCLUSION: In the early postoperative period, the use of propofol prevents PONV.

Comparison of Isoflurane and Propofol Anesthesia on Postoperative Nausea, Vomiting and Recovery after Tonsillectomy in Children / 대한마취과학회지

BACKGROUND: The purpose of this study was to compare prospectively two different anesthetic techniques with isoflurane or propofol for postoperative nausea, vomiting and recovery after tonsillectomy in children. METHODS: Sixty children, ASA physical status I, were assigned randomly to one of two groups. In group I, anesthesia was induced with thiopental 5 mg/kg and maintained with isoflurane 1~1.5 vol%. In group P, anesthesia was induced with fentanyl 1 mcg/kg, propofol 2 mg/kg and maintained with propofol infusion 5~10 mg/kg/hr. Both group received vecuronium 0.1 mg/kg for tracheal intubation and were ventilated with 33% O2 in N2O. The time to extubation, time to eye opening, PACU time, incidence and numbers of postoperative nausea and vomiting, and degree of sedation were recorded as well as perioperative complications. RESULTS: There were no significant difference in the duration of anesthesia and PACU time between two groups. The time to extubation and eye opening of group P were significantly shorter than group I (p<0.05). The degree of sedation and incidence of postoperative nausea and vomiting of group P were significantly lower than group I (p<0.05). But the frequency of intraoperative bradycardia was significantly higher in group P than group I (p<0.05). CONCLUSIONS: Propofol-fentanyl anesthesia results in less nausea and vomiting during postoperative period and more rapid recovery compared to isoflurane anesthesia and may be recommended in children undergoing tonsillectomy and adenoidectomy.