The Journal of Medical Sciences

Register      Login

VOLUME 1 , ISSUE 4 ( October-December, 2015 ) > List of Articles

RESEARCH ARTICLE

Postoperative Nausea and Vomiting in Day Care Patients: A Comparative Randomized Controlled Trial of Total Intravenous Anesthesia with Propofol, Air, and Oxygen vs Inhalation Anesthesia with Isoflurane and Nitrous Oxide

A Sandhya, R Mamatha, Antara Banerjee

Citation Information : Sandhya A, Mamatha R, Banerjee A. Postoperative Nausea and Vomiting in Day Care Patients: A Comparative Randomized Controlled Trial of Total Intravenous Anesthesia with Propofol, Air, and Oxygen vs Inhalation Anesthesia with Isoflurane and Nitrous Oxide. J Med Sci 2015; 1 (4):63-68.

DOI: 10.5005/jp-journals-10045-0019

Published Online: 00-12-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

We compared the incidence of postoperative nausea and vomiting (PONV) after total intravenous anesthesia (TIVA) using propofol–air to inhalational anesthesia with isoflurane–nitrous oxide in day care patients at a tertiary care academic institution.

Materials and methods

We randomized 60 patients and assigned to either group I (inhalational anesthesia with isoflurane– nitrous oxide) or group II (TIVA with propofol–air). Incidence of PONV, use of anti-emetics, and duration of stay in the recovery were recorded for 72 hours by blinded observers.

Results

Total intravenous anesthesia reduced the PONV up to 72 hours by 27% among our patients (from 37 to 10%, p < 0.001). This effect was seen more in the early postoperative period. Overall, 13.3% of patients in the group I received antiemetic compared to 40% in group II. In our study, patients without PONV were discharged from the recovery room 15 minutes earlier after TIVA than after isoflurane and N2O anesthesia.

Conclusion

Total intravenous anesthesia with propofol and air resulted in a reduction of PONV compared with iso-flurane–nitrous oxide anesthesia. Overall, patients in group I required less rescue antiemetic, compared to group II. Total intravenous anesthesia resulted in shorter stay in the postoperative anesthetic care unit compared to isoflurane–N2O group.

How to cite this article

Sandhya A, Mamatha R, Banerjee A, Sahajananda H. Postoperative Nausea and Vomiting in Day Care Patients: A Comparative Randomized Controlled Trial of Total Intravenous Anesthesia with Propofol, Air, and Oxygen vs Inhalation Anesthesia with Isoflurane and Nitrous Oxide. J Med Sci 2015;1(4):63-68.


PDF Share
  1. Randomized controlled trial of total intravenous anesthesia with propofol vs inhalation anesthesia with isoflurane–nitrous oxide: postoperative nausea and vomiting and economic analysis. Anesthesiology 2001 Sep;95(3:)616-626.
  2. Subhypnotic doses of propofol possess direct antiemetic properties. Anesth Analg 1992 Apr;74(4:)539-541.
  3. Early and late recovery after major abdominal surgery: comparison between propofol anaesthesia with and without nitrous oxide and isoflurane anaesthesia. Acta Anaesthesiol Scand 1993 Nov;37(8:)730-736.
  4. Total intravenous anaesthesia with propofol and alfentanil protects against postoperative nausea and vomiting. Can J Anaesth 1992 Jan;39(1:)37-40.
  5. Postoperative nausea and vomiting: a comparison between intravenous and inhalation anaesthesia in breast surgery. Acta Anaesthesiol Scand 1994 Jan;38(1:)52-65.
  6. Nausea and vomiting after laparoscopic surgery: a comparison of propofol and thiopentone/halothane anaesthesia. Eur J Anaesthesiol 1996 Jan;13(1:)3-9.
  7. Propofol anaesthesia and postoperative nausea and vomiting: quantitative systematic review of randomized controlled studies. Br J Anaesth 1997 Mar;78(3:)247-255.
  8. A meta-analysis of nausea and vomiting following maintenance of anaesthesia with propofol or inhalational agents. Eur J Anaesthesiol 1998 Jul;15(4:)433-445.
  9. The study of postoperative nausea and vomiting. Br J Anaesth 1992;69(7 Suppl 1:)20S-23S.
  10. Physiology of nausea and vomiting. Br J Anaesth 1992;69(7 Suppl 1:)2S-19S.
  11. Effective concentration 50 for propofol with and without 67% nitrous oxide. Acta Anaesthesiol Scand 1993 Jul;37(5:)458-464.
  12. Total intravenous anaesthesia – free from nitrous oxide, free problems? Acta Anaesthesiol Scand 1994 Nov;38(8:)769-770.
  13. Omitting nitrous oxide in general anaesthesia: meta-analysis of intraoperative awareness and postoperative emesis in randomized controlled trials. Br J Anaesth 1996 Feb;76(2:)186-193.
  14. Nitrous oxide: still useful in the year 2000? Curr Opin Anaesthesiol 1999 Jul;12(4:)461-466.
  15. Omission of nitrous oxide during anesthesia reduces the incidence of postoperative nausea and vomiting: a meta-analysis. Anesthesiology 1996 Nov;85(5:)1055-1062.
  16. Cost aspects in anesthesia: propofol vs isoflurane anesthesia [Article in German]. Anaesthetist 1996 Aug;45(8:)731-736.
  17. Total intravenous anaesthesia with propofol or inhalational anaesthesia with isoflurane for major abdominal surgery: recovery characteristics and postoperative oxygenation – an inter-national multicentre study. Anaesthesia 1996 Nov;51(11:)1055-1059.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.