Clinical Observation of Postoperative Nausea and Vomiting in Patients Undergone Gynecological Laparoscopy under Total Intravenous Anesthesia / 中国微创外科杂志

ABSTRACT

Objective To assess the incidence rate of postoperative nausea and vomiting (PONV) after total intravenous anesthesia (TIVA) with propofol versus sevoflurane-based anesthesia with or without ondansetron in patients undergone gynecological laparoscopy. Methods Totally 138 patients were randomly divided into three groups sevoflurane group (Sev group) sevoflurane-ondansetron group (Sev-O group),and propofol TIVA group (TIVA group),with 46 cases in each. In the Sev and Sev-O groups,anesthesia was maintained by inhalation of 50% N2O and sevoflurane;in the Sev-O group,8 mg of prophylactic ondansetron was given intravenously 30 minutes prior to the end of the operation. In the TIVA group,target-controlled infusion of propofol and remifentanil were used. In each group,the incidence of nausea and vomiting and use of antiemetic drugs in 24 hours after the surgery were recorded. Results In 0 to 2 hours after the operation,the incidence rate of nausea and vomiting in the TIVA group was significantly lower than that in the Sev group [22% (10/46) vs 54% (25/46),?2=10.376,P=0.001] and Sev-O group [50% (23/46),?2=7.986,P=0.005]. In 2-6 hours,the rate in the Sev-O group was lower than that in the Sev group [22% (10/46) vs 46% (21/46),?2=5.887,P=0.015]. The total incidence rate of nausea and vomiting in 24 hours after the operation was 57% (26/46) in the TIVA group,which was significantly lower than that in the Sev group [80% (37/46),?2=6.093,P=0.014]. In the Sev,Sev-O,and TIVA groups,there were 13 (28%),6 (13%),and 6 (13%) cases respectively received antiemetic drugs after the surgery. Conclusions Compared with sevoflurane-based anesthesia,propofol TIVA results in a lower rate of PONV after gynecological laparoscopy.