title: Postoperative nausea and vomiting after mastoidectomy with tympanoplasty: a comparison between TIVA with propofol-remifentanil and balanced anesthesia with sevoflurane-remifentanil.
abstract: BACKGROUND
  There is growing interest in the anesthetic approach using total intravenous anesthesia (TIVA) with propofol and remifentanil for the prevention of postoperative nausea and vomiting (PONV). The aim of this study was to compare between the two anesthetic techniques for preventing PONV in the patients undergoing mastoidectomy with tympanoplasty.
  
  
  METHODS
  After obtaining informed consent, 62 patients aged between 20 to 60 years undergoing elective mastoidectomy and tympanoplasty were randomized into two equal study groups: group P/R (n = 31) included patients undergoing TIVA with propofol and remifentanil, and group S/R (n = 31) included patients undergoing balanced anesthesia with sevoflurane and remifentanil. The incidences of PONV and complete response (no PONV, no rescue) were assessed at 1 and 24 h after surgery, using the Rhodes Index. Also, the usage of rescue antiemetics and pain intensity were recorded.
  
  
  RESULTS
  The Rhodes Index including the occurrence score, distress score and experience score was significantly lower in the P/R group compared to that in the S/R group during the study period (P < 0.05), and the incidence of complete response was significantly higher in the P/R group compared to that in the S/R group, during the first 24 h after surgery. 4 patients in the S/R group requested antiemetics during the first 1 h after surgery. There were no significant differences in pain intensity among groups.
  
  
  CONCLUSIONS
  Compared to balanced anesthesia with sevoflurane and remifentanil, TIVA with propofol and remifentanil was followed by significantly lower incidence and severity of PONV.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University, Medical School, Gwangju, Korea.
authors.forename: Dae Wook
authors.initials: DW
authors.lastname: Lee
authors.forename: Hyung Gon
authors.initials: HG
authors.lastname: Lee
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Jeong
authors.forename: Seong Wook
authors.initials: SW
authors.lastname: Jeong
authors.forename: Seong Heon
authors.initials: SH
authors.lastname: Lee