title: Target Controlled Infusion versus Sevoflurane/Desflurane Anesthesia for Laparoscopic Cholecystectomy: Comparison Postoperative Nausea/Vomiting and Extubation Time.
abstract: BACKGROUND
  Target-controlled infusion (TCI) systems have been developed from manually controlled infusion systems and have rapidly increased in popularity, especially in laparoscopic surgery. Propofol is claimed to decrease nausea and vomiting.
  
  
  OBJECTIVE
  To compare anesthetic techniques, propofol-TCI, desflurane, and sevoflurane, for better results in terms of postoperative nausea and vomiting (PONV) and extubation times.
  
  
  METHODS
  The present study was prospective with informed consent from 75 patients, ASA 1-3 scheduled for laparoscopic cholecystectomy, and classified by anesthetic technique into three groups. The patients were induced by propofol target plasma concentration 6 µg/ml in Group P, or 1-2 mg/kg in Group S and Group D, fentanyl 2 µg/kg and vecuronium 0.1 mg/kg followed by propofol 2 to 5 µg/mI in group P, sevoflurane 0.5 to 3% in Group S, and desflurane 2 to 6% in Group D.
  
  
  RESULTS
  The incidence of postoperative nausea and vomiting was least in Group P, both at the PACU (p < 0.001) and ward (p = 0.01). Extubation time excluding outlier were Group P 11.17 ± 1.19 minutes, Group D 13.96 ± 1.17 minutes, Group S 11.75 ± 1.34 minutes (p = 0.25). There were no statistical differences in the amount of fentanyl (p = 0.38) and fluid replacements (p = 0.05).
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy under propofol with TCI is one option of anesthetic technique with a significantly lower incidence of PONV compared with both sevoflurane and desflurane otherwise there is no statistical difference in the extubation time. Propofol-TCI technique is suggested for laparoscopic and ambulatory surgery.
authors.forename: Sumidtra
authors.initials: S
authors.lastname: Prathep
authors.forename: Sasithorn
authors.initials: S
authors.lastname: Mahattanaporn
authors.forename: Wirat
authors.initials: W
authors.lastname: Wasinwong
mesh_terms: D000328:Adult; D060666:Airway Extubation / Q000379:methods; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods; D000077335:Desflurane; D016503:Drug Delivery Systems / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D000077149:Sevoflurane; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; D005283:Fentanyl; D015742:Propofol