title: Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery.
abstract: BACKGROUND
  We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery.
  
  
  METHODS
  Patients were randomly divided into three groups: those maintained with sevoflurane (Group S, n=42), propofol (Group P, n=42), or combined propofol and sevoflurane (Group PS, n=42). We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use), incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24h after surgery.
  
  
  RESULTS
  The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2h (74%, 76% and 43%, respectively, p=0.001) and 0-24h (71%, 76% and 38%, respectively, p<0.0005). The incidence of nausea at 0-2h (Group S=57%, Group P=26% and Group PS=21%, p=0.001) and 0-24h (Group S=62%, Group P=29% and Group PS=21%, p<0.0005) was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24h.
  
  
  CONCLUSIONS
  Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. We term this novel method of anesthesia "combined intravenous-volatile anesthesia (CIVA)".
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan. Electronic address: hir.kawano@gmail.com.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Ohshita
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Kimiko
authors.initials: K
authors.lastname: Katome
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Kadota
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Kinoshita
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Matsuoka
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Yasuo M
authors.initials: YM
authors.lastname: Tsutsumi
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawahito
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Shuzo
authors.initials: S
authors.lastname: Oshita
mesh_terms: D000328:Adult; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000932:Antiemetics / Q000627:therapeutic use; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000453:epidemiology*; D015742:Propofol / Q000008:administration & dosage*; D000077149:Sevoflurane; D013997:Time Factors; D055815:Young Adult
chemical_list: D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000932:Antiemetics; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol
keywords: Anestesia geral; General anesthesia; Laparoscopia; Laparoscopy; Náusea e vômito pós-operatórios; Postoperative nausea and vomiting; Propofol; Sevoflurane; Sevoflurano