Sir Humphry Davy Department of Anaesthesia, Bristol Royal Infirmary, UK.
Title
Total intravenous anaesthesia with propofol and alfentanil protects
against postoperative nausea and vomiting.
Source
Canadian Journal of Anaesthesia. 39(1):37-40, 1992 Jan.
Abstract
The incidence of postoperative nausea and vomiting and requirements for
anti-emetic medication were assessed in 80 female patients undergoing
day-case anaesthesia during assisted conception therapy. Anaesthesia was
induced with alfentanil 50 micrograms.kg-1 and propofol 1 mg.kg-1;
atracurium 0.5 mg.kg-1 was given to facilitate tracheal intubation. The
patients were allocated to receive either total intravenous maintenance of
anaesthesia with an infusion of propofol and increments of alfentanil (Group
P) or inhalational maintenance of anaesthesia with nitrous oxide and
enflurane (Group E). Postoperative nausea, retching, vomiting, requirements
for anti-emetic therapy, and unplanned admission for overnight stay in
hospital were recorded. Overall incidence of nausea was 64% in group E and
39% in Group P (P less than 0.05). Incidence of vomiting was 67% in Group E
and 34% in Group P (P less than 0.05). Metoclopramide was requested by 62%
of patients in Group E, and 32% of those in Group P (P less than 0.05); 21%
of the patients in Group E were admitted to hospital overnight, while only
5% of the patients in Group P required unscheduled admission to hospital (P
less than 0.05). We conclude that total intravenous anaesthesia with
propofol and alfentanil is superior to inhalational maintenance with nitrous
oxide and enflurane in that it is associated with less nausea and vomiting,
less requirement for anti-emetic medication, and a lower probability of
unplanned admission to hospital after day-care gynaecological surgery.