The risk of postoperative nausea and vomiting between surgical patients received propofol and sevoflurane anesthesia: A matched study.
OBJECTIVE
The current consensus guidelines for managing postoperative nausea and vomiting (PONV) suggest that one of anesthetic risk factors is the use of volatile anesthetics. However, in clinical settings, it is rare to perceive propofol to be superior to volatile anesthetics for the prevention of PONV. To assess whether PONV is related to the type of anesthetic delivered, we compared the incidence and duration of PONV between propofol anesthesia and sevoflurane anesthesia.


METHODS
We performed a retrospective review of an institutional registry containing 21606 general anesthesia cases conducted following ethics board approval. Anesthesia for all patients was managed with propofol or sevoflurane. To avoid channeling bias, a propensity score analysis was used to generate a set of matched cases (propofol anesthesia) and controls (sevoflurane anesthesia), yielding 2554 matched patient pairs. The incidence and sustained rate of symptoms were compared as the primary outcomes.


RESULTS
In the unmatched population, a higher incidence of PONV occurred following propofol anesthesia compared to sevoflurane anesthesia (propofol vs. sevoflurane anesthesia: 18.9% vs. 15.3%, respectively, p < 0.0001). The sustained rate of PONV over the course after propofol anesthesia was also higher than that following sevoflurane anesthesia (p < 0.001). Conversely, less PONV occurred after propofol compared to sevoflurane after propensity matching (propofol vs. sevoflurane anesthesia: 20.4% vs. 23.3%, respectively, p = 0.01). However, the sustained rate of PONV over the course after propofol anesthesia did not differ from that following sevoflurane anesthesia (p = 0.09).


CONCLUSIONS
Propofol could decrease the incidence of PONV compared with sevoflurane, although the duration of PONV was not affected as found in previous reports.
Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho Kashihara, Nara 634-8522, Japan.
Hideki
H
Matsuura
Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho Kashihara, Nara 634-8522, Japan. Electronic address: seninoue@naramed-u.ac.jp.
Satoki
S
Inoue
Department of Anesthesiology and Division of Intensive Care, Nara Medical University, 840 Shijo-cho Kashihara, Nara 634-8522, Japan.
Masahiko
M
Kawaguchi
D000328:Adult; D000368:Aged; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008738:Methyl Ethers / Q000009:adverse effects*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000209:etiology*; D015742:Propofol / Q000009:adverse effects*; D012189:Retrospective Studies; D012306:Risk; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol
PONV; Propofol; Sevoflurane