Anaesthesia, recovery and postoperative nausea and vomiting after breast surgery. A comparison between desflurane, sevoflurane and isoflurane anaesthesia

Abstract

The quality of anaesthesia, time to opening of eyes and influence on respiration was similar with all three anaesthetics. As the emergence from anaesthesia did not differ significantly between the three agents, the choice of agent could be based on PONV rate and price. Desflurane had a significantly higher 24 h PONV rate than isoflurane. Early PACU PONV rate was significantly (P<0.05) lower for the more soluble isoflurane (4%) than for the low soluble gases, desflurane and sevoflurane together (28%). The result of this study does not give a rationale for a transition to the new low soluble agents in breast cancer surgery.

Omission of fentanyl during sevoflurane anesthesia decreases the incidences of postoperative nausea and vomiting and accelerates postanesthesia recovery in major breast cancer surgery

“…The incidence of nausea during the first 24 postoperative hours in group SF (68%) was almost comparable with that in previous reports of anesthesia without the use of prophylactic antiemetics (33%-85%) in major breast surgery [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Many factors are thought to be involved in the high incidence of PONV [18,21].…”

“…It has been recognized that major breast surgery is associated with a high incidence of PONV [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]18,21], and PONV is the major limiting factor for performing such surgery as a day procedure [11,21]. The incidence of nausea during the first 24 postoperative hours in group SF (68%) was almost comparable with that in previous reports of anesthesia without the use of prophylactic antiemetics (33%-85%) in major breast surgery [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

“…Breast cancer surgery performed under general anesthesia using a volatile anesthetic is associated with high incidences (33%-85%) of postoperative nausea and vomiting (PONV) [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Recently, not only minor breast operations, such as lumpectomy, but major operations, such as mastectomy, have been performed as ambulatory surgery or "drive-through mastectomy" in order to decrease healthcare costs and improve the patients' emotional and psychological well-being [11,[15][16][17].…”

Emergence and Recovery Characteristics After Low Flow Anaesthesia With Desflurane and Sevoflurane in Cancer Patients Administered Combined Epidural and General Anaesthesia

“…This is in contrast to a study by Karlsenet al who reported a higher incidence of postoperative nausea/vomiting rate (24 hour in PACU and ward) with desflurane (67%) and sevoflurane (36%). [12] The combined approach of administering intraoperative opiates, local anesthesia, and NSAIDs is associated with significantly shorter discharge times, lower pain scores, and a lower incidence of nausea and vomiting, compared with traditional opiate-based anesthetic technique. Limitations of this study are due to its inherent design which does not permit a double-blind comparison of the two volatile anaesthetics.…”

Does intravenous dexamethasone prevent nausea and vomiting after reduction mammoplasty?

“…Additionally, persistent nausea and vomiting can delay discharge from hospital (1,2). Breast surgery is associated with a high (40% to 70%) incidence of PONV (3,4).…”