title: Post-operative nausea and vomiting (PONV) after thyroid surgery: a prospective, randomized study comparing totally intravenous versus inhalational anesthetics.
abstract: The incidence of postoperative nausea and vomiting (PONV) after thyroidectomy and the association of Propofol versus Sevoflurane use for anesthesia maintenance were investigated during a randomized, prospective study. One hundred and ninety-eight patients underwent thyroidectomy receiving either Sevoflurane (0.5-1.3% end-tidal) or Propofol (50-200 mg/kg/min) for anesthesia maintenance. All patients received Propofol for induction of anesthesia, Succinylcholine or Vecuronium, Nitrous Oxide, and Fentanyl. Prophylactic antiemetics were not administered. The combined incidence of PONV was 54.4 per cent over the 24-hour postoperative evaluation period. PONV was more common in patients receiving Sevoflurane than Propofol for maintenance of anesthesia (64.6% vs 43.8%). In women (n = 117), the incidence of PONV resulted higher when receiving inhalational Sevoflurane than Propofol for maintenance (70.6% vs 42.4%). However, in men (n = 81), there was no significant difference in PONV between anesthetic regimens (47.4% with Sevoflurane vs 49.6% with Propofol). Patients undergoing thyroid surgery are at high risk for the development of PONV. Propofol for maintenance of anesthesia, although more expensive than Sevoflurane, may reduce the rate of PONV.
authors.affiliation: Department of Anesthesiology, Intensive Care and Pain Therapy, "Sapienza" University School of Medicine, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vari
authors.forename: Sergio
authors.initials: S
authors.lastname: Gazzanelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cavallaro
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Toma
authors.forename: Sergio
authors.initials: S
authors.lastname: Tarquini
authors.forename: Carolina
authors.initials: C
authors.lastname: Guerra
authors.forename: Elisa
authors.initials: E
authors.lastname: Stramaccioni
authors.forename: Paolo
authors.initials: P
authors.lastname: Pietropaoli
mesh_terms: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery; D006801:Humans; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D015742:Propofol; D011446:Prospective Studies; D000077149:Sevoflurane; D013959:Thyroid Diseases / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol