title: Effects of intraoperative single bolus fentanyl administration and remifentanil infusion on postoperative nausea and vomiting.
abstract: BACKGROUND
  Although the use of postoperative opioids is a well-known risk factor for postoperative nausea and vomiting (PONV), few studies have been performed on the effects of intraoperative opioids on PONV. We examined the effects of a single bolus administration of fentanyl during anesthesia induction and the intraoperative infusion of remifentanil on PONV.
  
  
  METHODS
  Two hundred and fifty women, aged 20 to 65 years and scheduled for thyroidectomy, were allocated to a control group (Group C), a single bolus administration of fentanyl 2 µg/kg during anesthesia induction (Group F), or 2 ng/ ml of effect-site concentration-controlled intraoperative infusion of remifentanil (Group R) groups. Anesthesia was maintained with sevoflurane and 50% N2O. The incidence and severity of PONV and use of rescue antiemetics were recorded at 2, 6, and 24 h postoperatively.
  
  
  RESULTS
  Group F showed higher incidences of nausea (60/82, 73% vs. 38/77, 49%; P = 0.008), vomiting (40/82, 49% vs. 23/77 30%; P = 0.041) and the use of rescue antiemetics (47/82, 57% vs. 29/77, 38%; P = 0.044) compared with Group C at postoperative 24 h. However, there were no significant differences in the incidence of PONV between Groups C and R. The overall incidences of PONV for postoperative 24 h were 49%, 73%, and 59% in Groups C, F, and R, respectively (P = 0.008).
  
  
  CONCLUSIONS
  A single bolus administration of fentanyl 2 µg/kg during anesthesia induction increases the incidence of PONV, but intraoperative remifentanil infusion with 2 ng/ml effect-site concentration did not affect the incidence of PONV.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Hyungsun
authors.initials: H
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: A Ram
authors.initials: AR
authors.lastname: Doo
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Ji-Seon
authors.initials: JS
authors.lastname: Son
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Jin-Wan
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Ki-Jae
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Dong-Chan
authors.initials: DC
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.
authors.forename: Seonghoon
authors.initials: S
authors.lastname: Ko
keywords: Fentanyl; Intraoperative period; Postoperative nausea and vomiting; Remifentanil