title: A randomized controlled trial of two different interventions for the prevention of postoperative nausea and vomiting: total intravenous anaesthesia using propofol and remifentanil versus prophylactic palonosetron with inhalational anaesthesia using sevoflurane-nitrous oxide.
abstract: Total intravenous anaesthesia (TIVA) can reduce the risk of postoperative nausea and vomiting (PONV) almost as much as a single antiemetic. This study compared TIVA (using propofol and remifentanil) with prophylactic palonosetron (a 5-hydroxytryptamine type 3 receptor antagonist) combined  with inhalation anaesthesia using sevoflurane in 50% nitrous oxide, for the prevention of PONV. Patients were randomly assigned to one of two prophylactic interventions: (i) palonosetron 0.075 mg, intravenously before induction of inhalation anaesthesia (palonosetron group); and (ii) TIVA  (propofol target blood concentration 2.5-6.0 μg/ml; remifentanil target blood concentration 2.5-6.0 ng/ml; TIVA group). Nausea/vomiting occurrence and severity were monitored immediately after the end of surgery for 24 h. The incidence of PONV was around 50% in both groups and  the severity of nausea was similar in both groups. Prophylactic palonosetron with inhalational anaesthesia using sevoflurane in 50% nitrous oxide reduced the incidence of PONV after gynaecological laparoscopic surgery almost as much as TIVA using propofol and remifentanil.
authors: Department of Anaesthesiology and Pain Medicine, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors: S K
authors: SK
authors: Park
authors: E J
authors: EJ
authors: Cho
mesh_terms: D000328:Adult; D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000932:Antiemetics / Q000008:administration & dosage*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage; D010535:Laparoscopy; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D009609:Nitrous Oxide / Q000008:administration & dosage; D000077924:Palonosetron; D010880:Piperidines / Q000008:administration & dosage; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage; D011812:Quinuclidines / Q000008:administration & dosage; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000932:Antiemetics; D007546:Isoquinolines; D008738:Methyl Ethers; D010880:Piperidines; D011812:Quinuclidines; D000077149:Sevoflurane; D000077924:Palonosetron; D009609:Nitrous Oxide; D000077208:Remifentanil; D015742:Propofol