Korean J Anesthesiol.  2017 Jun;70(3):299-304. 10.4097/kjae.2017.70.3.299.

Postoperative nausea and vomiting after thyroidectomy: a comparison between dexmedetomidine and remifentanil as part of balanced anesthesia

• Choi EK
• Seo Y
• Lim DG
• Park S

• KMID: 2382746
• DOI: http://doi.org/10.4097/kjae.2017.70.3.299

Abstract

BACKGROUND
Postoperative nausea and vomiting (PONV) is the major complication related to general anesthesia, occurring in 60-80% of patients after thyroidectomy. The objective of this study was to compare the effects of an intraoperative dexmedetomidine infusion with remifentanil, as anesthetic adjuvants of balanced anesthesia, on PONV in patients undergoing thyroidectomy.
METHODS
Eighty patients scheduled for thyroidectomy were randomized into the following two groups: 1) The dexmedetomidine group (Group D), who received an initial loading dose of dexmedetomidine (1 µg/kg over 10 min) during the induction of anesthesia, followed by a continuous infusion at a rate of 0.3-0.5 µg/kg/h; 2) the remifentanil group (group R), who received remifentanil at an initial target effect site concentration of 4 ng/ml during the induction of anesthesia, followed by a target effect site concentration of 2-3 ng/ml. PONV was assessed during the first 24 hours in 2 time periods (0-2 h and 2-24 h). The pain intensity, sedation score, extubation time, and hemodynamics were also assessed.
RESULTS
During the 2 time periods, the incidence and severity of PONV in group D were significantly lower than in group R. In addition, the need for rescue antiemetics was significantly lower in group D than in group R. The effect of dexmedetomidine on postoperative pain relief (2-24 h) was superior to that of remifentanil. The hemodynamics were similar in both groups, whereas eye opening and extubation time were delayed in group D.
CONCLUSIONS
Adjuvant use of intraoperative dexmedetomidine infusion may be effective for the prevention of PONV.

Keyword

Dexmedetomidine; Postoperative nausea and vomiting; Remifentanil

MeSH Terms

Adjuvants, Anesthesia
Anesthesia
Anesthesia, General
Antiemetics
Balanced Anesthesia*
Dexmedetomidine*
Hemodynamics
Humans
Incidence
Pain, Postoperative
Postoperative Nausea and Vomiting*
Thyroidectomy*
Adjuvants, Anesthesia
Antiemetics
Dexmedetomidine