Korean J Anesthesiol.  2011 Jun;60(6):416-421. 10.4097/kjae.2011.60.6.416.

Postoperative nausea and vomiting after endoscopic thyroidectomy: total intravenous vs. balanced anesthesia

• Kim GH
• Ahn HJ
• Kim HS
• Bang SR
• Cho HS
• Yang M
• Kim JA

• KMID: 1766655
• DOI: http://doi.org/10.4097/kjae.2011.60.6.416

Abstract

BACKGROUND
Endoscopic thyroidectomy was recently introduced and has been rapidly accepted by surgeons and patients. The present study was conducted to estimate and compare the incidences of postoperative nausea and vomiting (PONV) after endoscopic thyroidectomy using two different anesthetic methods: sevoflurane based balanced anesthesia; total intravenous anesthesia (TIVA).
METHODS
Ninety nine female patients that were scheduled to undergo elective endoscopic thyroidectomy under general anesthesia were enrolled. These patients were randomly allocated to receive sevoflurane based balanced anesthesia (BA group) or propofol-remifentanil anesthesia (TIVA group). PONV was evaluated using a 4-point Likert scale, and pain using a visual analogue scale (VAS; range 0 to 100) for 0-2, 2-6, and 6-24 hours postoperatively. At 24 hours postoperatively, overall patient satisfaction regarding PONV and pain were recorded.
RESULTS
The incidence of PONV was 14.6% in the TIVA group and 51.3% in the BA group. The incidence of nausea at 0-2 and 2-6 hours postoperatively was lower in the TIVA group than in the BA group (4.2% vs. 35.9%, 6.3% vs. 23.1%, respectively), but no between-group difference was observed at 6-24 hours postoperatively (8.3% vs. 5.1%). Antiemetic usage at 0-2 and 2-6 hours was lower in the TIVA than the BA group (4.2% vs. 38.5%, 6.3% vs. 23.1%), but no between-group difference was observed for 6-24 hours (6.3% vs. 7.7%). There were no differences in pain or in patient satisfaction.
CONCLUSIONS
After endoscopic thyroidectomy, total intravenous anesthesia with propofol-remifentanil is associated with less PONV during the early postoperative period (0-6 hours) than sevoflurane based balanced anesthesia.

Keyword

Endoscopic surgery; PONV; Thyroidectomy

MeSH Terms

Anesthesia
Anesthesia, General
Anesthesia, Intravenous
Balanced Anesthesia
Female
Humans
Incidence
Methyl Ethers
Nausea
Patient Satisfaction
Postoperative Nausea and Vomiting
Postoperative Period
Thyroidectomy
Methyl Ethers