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Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery.
Acta Anaesthesiol Scand. 2005 Mar; 49(3):305-11.AA

Abstract

BACKGROUND

The effect of different opioids on postoperative nausea and vomiting (PONV) has not been conclusively determined yet, thus the aim of this study was to compare the incidence of PONV in propofol-anaesthetized patients receiving either fentanyl or remifentanil as opioid supplement.

METHODS

Sixty ASA physical status I and II patients scheduled for plastic surgery gave their written informed consent for this prospective, randomized, double-blind study. Anaesthesia was induced with propofol, rocuronium and fentanyl (n = 30; 2 microg kg(-1)) or remifentanil (n = 30; 1 microg kg(-1)). After tracheal intubation, anaesthesia was maintained with propofol, oxygen in air and an infusion of the opioid studied, which was modified according to clinical criteria. Baseline postoperative analgesia was achieved with intravenous propacetamol + metamizol. Intravenous morphine was given if visual analogic scale (VAS) for pain was > or = 4 (scale 0-10) and metoclopramide was administered if a patient presented > or = 2 PONV episodes (nausea or vomiting) in less than 30 min. Postoperatively (2, 12 and 24 h), we registered VAS, rescue morphine consumption, number of patients with episodes of PONV and number of patients requiring metoclopramide. P < 0.05 was considered significant.

RESULTS

There were no significant differences between groups in the demographic parameters, ASA physical status, propofol dose, VAS, and rescue morphine requirements. Fourteen patients in the fentanyl group and four in the remifentanil group presented PONV episodes 2-12 h postoperative hours' interval; (P < 0.05). Ten patients in the fentanyl group and four in the remifentanil group presented vomiting episodes in the same period (P < 0.05); and eight patients in the fentanyl group and one in the remifentanil group required metoclopramide; (P < 0.05). The number of postoperative PONV episodes were low, both in the 0-2-h period (n = 2 vs. n = 1, fentanyl and remifentanil, respectively) and in the 12-24-h period (n = 3 vs. n = 1).

CONCLUSION

Propofol + fentanyl anaesthesia resulted in a higher incidence of PONV and requirements of antiemetic drugs in the period between 2 and 12 postoperative hours compared with propofol + remifentanil, in patients undergoing plastic surgery.

Authors+Show Affiliations

Department of Anaesthesiology and Perioperative Medicine, Complejo Hospitalario Universitario Juan Canalejo, 15006 A Coruña, Spain. prmaceiras@wanadoo.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15752393

Citation

Rama-Maceiras, P, et al. "Less Postoperative Nausea and Vomiting After Propofol + Remifentanil Versus Propofol + Fentanyl Anaesthesia During Plastic Surgery." Acta Anaesthesiologica Scandinavica, vol. 49, no. 3, 2005, pp. 305-11.
Rama-Maceiras P, Ferreira TA, Molíns N, et al. Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery. Acta Anaesthesiol Scand. 2005;49(3):305-11.
Rama-Maceiras, P., Ferreira, T. A., Molíns, N., Sanduende, Y., Bautista, A. P., & Rey, T. (2005). Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery. Acta Anaesthesiologica Scandinavica, 49(3), 305-11.
Rama-Maceiras P, et al. Less Postoperative Nausea and Vomiting After Propofol + Remifentanil Versus Propofol + Fentanyl Anaesthesia During Plastic Surgery. Acta Anaesthesiol Scand. 2005;49(3):305-11. PubMed PMID: 15752393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Less postoperative nausea and vomiting after propofol + remifentanil versus propofol + fentanyl anaesthesia during plastic surgery. AU - Rama-Maceiras,P, AU - Ferreira,T A, AU - Molíns,N, AU - Sanduende,Y, AU - Bautista,A P, AU - Rey,T, PY - 2005/3/9/pubmed PY - 2005/9/24/medline PY - 2005/3/9/entrez SP - 305 EP - 11 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 49 IS - 3 N2 - BACKGROUND: The effect of different opioids on postoperative nausea and vomiting (PONV) has not been conclusively determined yet, thus the aim of this study was to compare the incidence of PONV in propofol-anaesthetized patients receiving either fentanyl or remifentanil as opioid supplement. METHODS: Sixty ASA physical status I and II patients scheduled for plastic surgery gave their written informed consent for this prospective, randomized, double-blind study. Anaesthesia was induced with propofol, rocuronium and fentanyl (n = 30; 2 microg kg(-1)) or remifentanil (n = 30; 1 microg kg(-1)). After tracheal intubation, anaesthesia was maintained with propofol, oxygen in air and an infusion of the opioid studied, which was modified according to clinical criteria. Baseline postoperative analgesia was achieved with intravenous propacetamol + metamizol. Intravenous morphine was given if visual analogic scale (VAS) for pain was > or = 4 (scale 0-10) and metoclopramide was administered if a patient presented > or = 2 PONV episodes (nausea or vomiting) in less than 30 min. Postoperatively (2, 12 and 24 h), we registered VAS, rescue morphine consumption, number of patients with episodes of PONV and number of patients requiring metoclopramide. P < 0.05 was considered significant. RESULTS: There were no significant differences between groups in the demographic parameters, ASA physical status, propofol dose, VAS, and rescue morphine requirements. Fourteen patients in the fentanyl group and four in the remifentanil group presented PONV episodes 2-12 h postoperative hours' interval; (P < 0.05). Ten patients in the fentanyl group and four in the remifentanil group presented vomiting episodes in the same period (P < 0.05); and eight patients in the fentanyl group and one in the remifentanil group required metoclopramide; (P < 0.05). The number of postoperative PONV episodes were low, both in the 0-2-h period (n = 2 vs. n = 1, fentanyl and remifentanil, respectively) and in the 12-24-h period (n = 3 vs. n = 1). CONCLUSION: Propofol + fentanyl anaesthesia resulted in a higher incidence of PONV and requirements of antiemetic drugs in the period between 2 and 12 postoperative hours compared with propofol + remifentanil, in patients undergoing plastic surgery. SN - 0001-5172 UR - https://www.unboundmedicine.com/medline/citation/15752393/Less_postoperative_nausea_and_vomiting_after_propofol_+_remifentanil_versus_propofol_+_fentanyl_anaesthesia_during_plastic_surgery_ L2 - https://doi.org/10.1111/j.1399-6576.2005.00650.x DB - PRIME DP - Unbound Medicine ER -