Total intravenous anesthesia with propofol reduces postoperative nausea and vomiting in patients undergoing robot-assisted laparoscopic radical prostatectomy: a prospective randomized trial

Young-Chul Yoo, Sun-Joon Bai, Ki-Young Lee, Seokyung Shin, Eun Kyeong Choi, Jong Whax Lee, Young-Chul Yoo, Sun-Joon Bai, Ki-Young Lee, Seokyung Shin, Eun Kyeong Choi, Jong Whax Lee

Abstract

Purpose: We investigated the effect of total intravenous anesthesia (TIVA) with propofol on postoperative nausea and vomiting (PONV) after robot-assisted laparoscopic radical prostatectomy (RLRP) in patients at low risk of developing PONV, in comparison to balanced anesthesia with desflurane.

Materials and methods: Sixty two patients were randomly assigned to the Des or TIVA group. Propofol and remifentanil were used for induction of anesthesia in both groups and for maintenance of the anesthesia in the TIVA group. In the Des group, anesthesia was maintained with desflurane and remifentanil. In both groups, postoperative pain was controlled using fentanyl-based intravenous patient controlled analgesia, and ramosetron 0.3 mg was administered at the end of surgery. The incidence of PONV, severity of nausea and pain, and requirements of rescue antiemetics and analgesics were recorded.

Results: The incidence of nausea in the post-anesthetic care unit was 22.6% in the Des group and 6.5% in the TIVA (p=0.001) group. The incidence of nausea at postoperative 1-6 hours was 54.8% in the Des group and 16.1% in the TIVA group (p=0.001). At postoperative 6-48 hours, there were no significant differences in the incidence of nausea between groups.

Conclusion: In order to prevent PONV after RLRP in the early postoperative period, anesthesia using TIVA with propofol is required regardless of patient-related risk factors.

Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
The incidence of moderate to severe PONV during postoperative 48 hours. PONV, postoperative nausea and vomiting; patients with moderate to severe PONV, patients with VNRS ≥4 or with retching or vomiting at either time period; Des, patients receiving balanced anesthesia; TIVA, patients receiving total intravenous anesthesia; PACU, post anesthetic care unit; VNRS, verbal numerical rating scale. *p<0.05 vs. Des group.

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