title: The twenty-degree reverse-Trendelenburg position decreases the incidence and severity of postoperative nausea and vomiting after thyroid surgery.
abstract: BACKGROUND
  In this randomized, single-blind, controlled study, we evaluated whether the 20 degrees reverse-Trendelenburg position had an effect on postoperative nausea and vomiting in patients undergoing thyroid surgery.
  
  
  METHODS
  Patients (n = 224) were given a standardized propofol anesthetic. Intraoperatively, patients were randomly assigned into two groups according to the tilt of the table maintained during surgery: patients were positioned with the neck extended and the table tilted with 20 degrees reverse-Trendelenburg or with the neck extended and the table positioned at a horizontal tilt. All episodes of postoperative nausea, vomiting, nausea severity score, frequency of vomiting, and the use of antiemetics were recorded during the first 24 h after anesthesia. We divided this time period into 0-3 h and 3-24 h.
  
  
  RESULTS
  During the 0-3 h postoperative period, all observed episodes were comparable between groups. However, during the 3-24 h and the overall postoperative period, the incidence of nausea and/or vomiting, the nausea severity score, and frequency of vomiting were significantly less in the 20 degrees reverse-Trendelenburg position.
  
  
  CONCLUSIONS
  The 20 degrees reverse-Trendelenburg position effectively ameliorates postoperative nausea and/or vomiting.
authors.affiliation: Department of Anesthesiology, Tokushima Municipal Hospital, Tokushima, Japan. kiyokorin@yahoo.co.jp
authors.forename: Kiyo
authors.initials: K
authors.lastname: Tominaga
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Nakahara
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D018475:Head-Down Tilt / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control*; D011187:Posture / Q000502:physiology*; D016037:Single-Blind Method; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery*