Anesth Pain Med.  2007 Jul;2(3):126-131.

The Effect of Anesthetics and Opioids for Postoperative Nausea and Vomiting in General Anesthesia

• Lyu KH
• Kim CH
• Han JI

Abstract

BACKGROUND: A number of anesthetic factors may influence the risk of postoperative nausea and vomiting (PONV) throughout various mechanisms. This study analyzed the effect of different anesthetics and opioids with regards to PONV.
METHODS
Ninety ASA physical status 1 and 2 patients, who were scheduled for minor orthopedic or plastic surgery, were randomly assigned for three groups to receive either propofol-fentanyl (Group PF), propofol-femifentanil (Group PR) or sevoflurane-fentanyl (Group SF). Anesthesia was induced with propofol or pentothal sodium, rocuronium and fentanyl (2microg/kg) or remifentanil (1microg/kg). Anesthesia was maintained with BIS (bispectral index) value in the range of 40-60 and blood pressure and heart rate within 20% of baseline. The incidence and severity score of PONV, the administration of metoclopramide, visual analogue scale (VAS) for pain were assessed at 2, 12, 24 hours postoperatively.
RESULTS
The incidence of PONV in SF group was significantly higher than in PF and PR group during 0-2 hours period (P < 0.05). The incidence of PONV in SF and PF group was significantly higher than in PR group during 2-12 h period (P < 0.05). There were no significant differences among the groups in gender, the administration of antiemetics and postoperative VAS.
CONCLUSIONS
With propofol based anesthesia, short-cting remifentanil resulted in a lower incidence of PONV during 2-12 h period than fentanyl. Propofol-fentanyl anesthesia decreases the incidence of PONV compared with sevoflurane-entanyl during 0-2 hours postoperatively.

Keyword

fentanyl; postoperative nausea and vomiting; propofol; remifentanil; sevoflurane

MeSH Terms

Analgesics, Opioid*
Anesthesia
Anesthesia, General*
Anesthetics*
Antiemetics
Blood Pressure
Fentanyl
Heart Rate
Humans
Incidence
Metoclopramide
Orthopedics
Postoperative Nausea and Vomiting*
Propofol
Sodium
Surgery, Plastic
Thiopental
Analgesics, Opioid
Anesthetics
Antiemetics
Fentanyl
Metoclopramide
Propofol
Sodium
Thiopental