Korean J Anesthesiol.  2016 Feb;69(1):51-56. 10.4097/kjae.2016.69.1.51.

Effects of intraoperative single bolus fentanyl administration and remifentanil infusion on postoperative nausea and vomiting

• Lim H
• Doo AR
• Son JS
• Kim JW
• Lee KJ
• Kim DC
• Ko S

• KMID: 2152860
• DOI: http://doi.org/10.4097/kjae.2016.69.1.51

Abstract

BACKGROUND
Although the use of postoperative opioids is a well-known risk factor for postoperative nausea and vomiting (PONV), few studies have been performed on the effects of intraoperative opioids on PONV. We examined the effects of a single bolus administration of fentanyl during anesthesia induction and the intraoperative infusion of remifentanil on PONV.
METHODS
Two hundred and fifty women, aged 20 to 65 years and scheduled for thyroidectomy, were allocated to a control group (Group C), a single bolus administration of fentanyl 2 microg/kg during anesthesia induction (Group F), or 2 ng/ ml of effect-site concentration-controlled intraoperative infusion of remifentanil (Group R) groups. Anesthesia was maintained with sevoflurane and 50% N2O. The incidence and severity of PONV and use of rescue antiemetics were recorded at 2, 6, and 24 h postoperatively.
RESULTS
Group F showed higher incidences of nausea (60/82, 73% vs. 38/77, 49%; P = 0.008), vomiting (40/82, 49% vs. 23/77 30%; P = 0.041) and the use of rescue antiemetics (47/82, 57% vs. 29/77, 38%; P = 0.044) compared with Group C at postoperative 24 h. However, there were no significant differences in the incidence of PONV between Groups C and R. The overall incidences of PONV for postoperative 24 h were 49%, 73%, and 59% in Groups C, F, and R, respectively (P = 0.008).
CONCLUSIONS
A single bolus administration of fentanyl 2 microg/kg during anesthesia induction increases the incidence of PONV, but intraoperative remifentanil infusion with 2 ng/ml effect-site concentration did not affect the incidence of PONV.

Keyword

Fentanyl; Intraoperative period; Postoperative nausea and vomiting; Remifentanil

MeSH Terms

Analgesics, Opioid
Anesthesia
Antiemetics
Female
Fentanyl*
Humans
Incidence
Intraoperative Period
Nausea
Postoperative Nausea and Vomiting*
Risk Factors
Thyroidectomy
Vomiting
Analgesics, Opioid
Antiemetics
Fentanyl