[Recovery from anaesthesia and incidence and intensity of postoperative nausea and vomiting following a total intravenous anaesthesia (TIVA) with S-(+)-ketamine/propofol compared to alfentanil/propofol].
BACKGROUND
Opioids contribute to postoperative nausea and vomiting (PONV). An intraoperative analgesia with S-(+)-ketamine will make opioid administration dispensable and may reduce postoperative analgesic requirements. The aim of the study was to record the incidence and intensity of PONV following a total intravenous anesthesia (TIVA) with S-(+)-ketamine/propofol (K/P) or alfentanil/propofol (A/P) as well as recovery from anaesthesia.


METHODS
A total of 145 patients received a TIVA with K/P or A/P. Recovery time,PONV, intensity of pain and overall acceptance of the delivered anaesthesia were recorded.


RESULTS
Recovery times were prolonged in the K/P group. Both groups had a comparable incidence of PONV (26% and 22% for K/P vs A/P, respectively), the intensity was low in both groups with a VAS of <6/100 mm at all times. The intensity of postoperative pain and analgesic requirement did not differ. Overall acceptance of the delivered anaesthesia was lower in the K/P group. Unpleasant dreams were not more common in the K/P group.


CONCLUSIONS
A TIVA with K/P did not reduce PONV when compared to A/P, but prolonged recovery.
St Pierre
M
M
Klinik für Anästhesiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen. michael.st.pierre@kfa.imed.uni-erlangen.de
Kessebohm
K
K
Schmid
M
M
Kundt
H J
HJ
Hering
W
W
D000293:Adolescent; D000368:Aged; D015760:Alfentanil; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous / Q000009:adverse effects; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D004325:Dreams / Q000187:drug effects; D005260:Female; D006801:Humans; D007649:Ketamine; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D015742:Propofol
D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D015760:Alfentanil; D007649:Ketamine; D015742:Propofol