title: Postoperative nausea and vomiting after total thyroidectomy: sevoflurane combined with prophylactic ramosetron vs. propofol-based total intravenous anesthesia.
abstract: BACKGROUND
  The frequent and distressing adverse events (AEs) of postoperative nausea and vomiting (PONV) are of major concern in 63-84% of adult patients undergoing thyroidectomy. We conducted this prospective study to compare two prophylactic strategies; sevoflurane combined with ramosetron and propofol-based total intravenous anesthesia in a homogenous group of non-smoking women undergoing total thyroidectomy.
  
  
  METHODS
  In the current prospective study, we enrolled a consecutive series of 64 female patients aged between 20 and 65 years with an American Society of Anesthesiologists physical status of I or II who were scheduled to undergo elective total thyroidectomy under general anesthesia. Patients were randomized to either the SR (sevoflurane and remifentanil) group or the TIVA group. We evaluated the incidence and severity of PONV, the use of rescue anti-emetics and the severity of pain during the first 24 h after surgery.
  
  
  RESULTS
  There were no significant differences in the proportion of the patients with a complete response and the Rhodes index, including the occurrence score, distress score and experience score, between the two groups. In addition, there were no significant differences in the proportion of the patients who were in need of rescue anti-emetics or analgesics and the VAS scores between the two groups.
  
  
  CONCLUSIONS
  In conclusion, TIVA and ramosetron prophylaxis reduced the expected incidence of PONV in women undergoing total thyroidectomy. In addition, there was no significant difference in the efficacy during the first 24 h postoperatively between the two prophylactic regimens.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University, Medical School, Gwangju, Korea.
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University, Medical School, Gwangju, Korea.
authors.forename: Hyung Gon
authors.initials: HG
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University, Medical School, Gwangju, Korea.
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Jeong
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University, Medical School, Gwangju, Korea.
authors.forename: Seong Wook
authors.initials: SW
authors.lastname: Jeong
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University, Medical School, Gwangju, Korea.
authors.forename: Seong Heon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University, Medical School, Gwangju, Korea.
authors.forename: Hwi Jin
authors.initials: HJ
authors.lastname: Kim
keywords: Postoperative nausea and vomiting; Propofol; Ramosetron; Thyroidectomy
references.citation: Korean J Anesthesiol. 2011 Aug;61(2):154-8
references.pmid: 21927687
references.citation: Anesth Analg. 2007 Dec;105(6):1615-28, table of contents
references.pmid: 18042859
references.citation: Anaesth Intensive Care. 1998 Dec;26(6):625-9
references.pmid: 9876788
references.citation: Anaesth Intensive Care. 2002 Apr;30(2):153-9
references.pmid: 12002921
references.citation: J Clin Anesth. 1997 Aug;9(5):398-402
references.pmid: 9257207
references.citation: Anesthesiology. 1992 Aug;77(2):275-80
references.pmid: 1379418
references.citation: Anaesthesia. 2004 Nov;59(11):1078-82
references.pmid: 15479315
references.citation: Eur J Anaesthesiol. 2008 Sep;25(9):756-62
references.pmid: 18426627
references.citation: Curr Drug Saf. 2008 Jan;3(1):27-34
references.pmid: 18690978
references.citation: J Anesth. 2013 Feb;27(1):29-34
references.pmid: 22965329
references.citation: Anesthesiology. 1992 Jul;77(1):162-84
references.pmid: 1609990
references.citation: Br J Anaesth. 1996 Oct;77(4):463-7
references.pmid: 8942329
references.citation: Anesthesiology. 2000 Apr;92(4):958-67
references.pmid: 10754614
references.citation: Surg Endosc. 2010 Apr;24(4):812-7
references.pmid: 19707823
references.citation: Am J Health Syst Pharm. 2005 Jun 15;62(12):1247-60; quiz 1261-2
references.pmid: 15947124
references.citation: Br J Anaesth. 2009 Oct;103(4):549-53
references.pmid: 19700442
references.citation: Masui. 1998 Jan;47(1):77-8
references.pmid: 9492504
references.citation: J Int Med Res. 2011;39(5):1808-15
references.pmid: 22117981
references.citation: Anesth Analg. 2001 Apr;92(4):934-42
references.pmid: 11273930
references.citation: Br J Anaesth. 2007 Apr;98(4):470-6
references.pmid: 17317757
references.citation: Anaesthesist. 1997 Sep;46(9):776-82
references.pmid: 9412258
references.citation: Br J Anaesth. 1991 Jul;67(1):41-8
references.pmid: 1859758
references.citation: Br J Anaesth. 2000 Dec;85(6):898-900
references.pmid: 11732527
references.citation: Anesthesiology. 1997 Jan;86(1):10-23
references.pmid: 9009935
references.citation: J Int Med Res. 2002 May-Jun;30(3):220-9
references.pmid: 12166338
references.citation: Br J Anaesth. 1992;69(7 Suppl 1):60S-62S
references.pmid: 1486015
references.citation: Oncol Nurs Forum. 1999 Jun;26(5):889-94
references.pmid: 10382187
references.citation: Eur J Anaesthesiol. 1998 Jul;15(4):433-45
references.pmid: 9699101