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

Shirakami, Gotaro; Teratani, Yuriko; Segawa, Hajime; Matsuura, Shogo; Shichino, Tsutomu; Fukuda, Kazuhiko

doi:10.1007/s00540-006-0413-x

Cited by 25 publications

(38 citation statements)

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“…The scientific evidence that is available today allows us to affirm that the goal of achieving an adequate postoperative analgesia comfort and PONV is only achieved with the use of analgesic techniques that are balanced or use multiple methods, which covers drugs such as paracetamol, the NSAIDs, the infiltration of the surgical wound and peripheral nerve blocks (PNB). The use of opiates increases the incidence of PONV (13). Complications of soft tissue, bone, joint and nerve tissues are also rare.…”

Section: Discussionmentioning

confidence: 99%

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients

et al. 2009

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Objectives: To assess the demographic characteristics and comorbidities of the group to be studied, as well as various quality indicators of a Major Ambulatory Surgery (MAS) program. Quantification of the surgical-anesthetic incidents. Study design: We aimed to perform a retrospective and descriptive analysis of disabled patients who had received oral ambulatory surgery under general anesthesia. Data obtained from the clinical history and telephone interview included the demographic characteristics, socioeconomic status, previous dental history, cause of the mental disability, degree of mental retardation, comorbidity measured according to the scale of the American Society of Anesthesiologists (ASA), anesthesia or preoperative surgical treatments, level of analgesia, length of stay, incidents in the Resuscitation Ward, the rate of substitution, suspensions, patients admitted, complications and the degree of patient satisfaction. Results: We included 112 oral surgery procedures performed on disabled patients who were treated under general inhalational anesthesia as part of MAS during the years 2006-2007. During this period, 577 restorations, 413 extractions, 179 sealants, 102 pulpectomies, 22 root canal treatments, 17 gingivectomies and 3 frenectomies were performed. A total of 75% (78 cases) of the patients had coexisting medical pathology. The average surgery time per patient was 72.69 ±29.78 minutes. The rate of replacement was 100%. The rate of suspension was 1.92%. The percentage of patients readmitted was 1.92%,due to significant bleeding in the mouth, which did not require treatment and the patients were discharged from hospital 24 hours after being admitted. The rate of patients who required re-hospitalization was 3.84%. Conclusions: The MAS performed in this group, despite being on patients with high comorbidity resulted in only a low number of medical incidents reported.

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Section: Discussionmentioning

confidence: 99%

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients

et al. 2009

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“…In fact, it is reported that the use of fentanyl in an ambulatory surgery setting increases PONV and delays post anesthesia recovery [2]. Because the opioid remifentanil is known for its extremely short half-life [10], it is reasonable to assume that its use would be associated with reduced opioid-related side-effects, such as PONV.…”

Section: Discussionmentioning

confidence: 99%

“…A written informed consent for data collection was preoperatively obtained from each of the patients. Exclusion criteria were as follows: all cases without the 100 mm visual analog scale (VAS) or verbal numerical rating scale (VNRS) for nausea within 24 h after the operation by any reasons [2,8]. All the case that met the exclusion criteria were excluded from further analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Trained DSU nurses directly interviewed each patient on the 'morning after surgery in a telephone call or by meeting the patient directly. Patients were asked about symptoms after DSU discharge with the VNRS, including PONV and the pain VAS, and the patients provided a score for satisfaction with the surgical operation and anesthesia procedure [2,8]. …”

Section: Methodsmentioning

confidence: 99%

“…Such merits include the following; increased number of annual surgical cases, decrease in the number of patients on the surgical-wait list, and reduction in hospital costs. Although ambulatory surgery is becoming useful and common, factors that can lead to its failure, including ineffective postoperative analgesia, postoperative drowsiness, and postoperative nausea and vomiting (PONV), have not been completely conquered [1,2]. A recent large sample-size study reported that postoperative nausea is observed in at least one of five patients [3-6].…”

Section: Introductionmentioning

confidence: 99%

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The impact of remifentanil on incidence and severity of postoperative nausea and vomiting in a university hospital-based ambulatory surgery center: a retrospective observation study

Hara

Hirota

Sato

et al. 2013

Korean J Anesthesiol

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BackgroundAmbulatory surgery, including short-stay surgery, has become a common choice in clinical practice. For the success of ambulatory surgery, perioperative care with safe and effective anesthesia and postoperative analgesia, which can reduce the occurrence of postoperative nausea and vomiting (PONV), is essential. The effect of remifentanil on the occurrence and severity of PONV has not been thoroughly examined, particularly, in an ambulatory surgery setting. Here, we investigate whether remifentanil influences the occurrence and severity of PONV in a university hospital-based ambulatory unit.MethodsWe retrospectively analyzed a total of 1,765 cases of patients who had undergone general anesthesia at our ambulatory surgery unit. Parameters, such as occurrence and severity of nausea, vomiting or retching, use of antiemetic drugs, amount of postoperative analgesic and patient satisfaction, were extracted from the records and analyzed between the groups that received and not received remifentanil.ResultsWithin 565 patients of the RF group, 39 patients (6.6%) experienced nausea, 7 patients (1.2%) experienced vomiting or retching, and 10 patients (1.8%) were given antiemetic; in addition, the maximum VAS value for nausea was 12.1 mm. In 1,200 patients of the non RF group, 102 patients (8.5%) experienced nausea, 19 patients (1.6%) experienced vomiting or retching, and 34 patients (2.8%) were given antiemetic, and the maximum VAS value was 13.2 mm. There were no statistically significant differences between the two groups.ConclusionsOur results indicate that remifentanil did not increase the occurrence of PONV in patients within the ambulatory surgery unit.

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Incidence of and risk factors for postoperative nausea and vomiting at a Japanese Cancer Center: first large-scale study in Japan

et al. 2012

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PurposeThe first purpose of this study was to determine the incidence of postoperative nausea and/or vomiting (PONV) 0–48 h after anesthesia at a Japanese cancer center. The second purpose of this study was to collect information on PONV risk factors, independently, in the categories of patient-related, anesthesia-related, and surgery-related factors.MethodsThe frequency of nausea and vomiting was prospectively investigated from 0 to 48 h after anesthesia in 1645 patients (11–94 years of age) at a single medical institution. The occurrence of nausea and vomiting and the use of antiemetics were recorded up to 48 h after anesthesia. Patient-related, anesthesia-related, and surgery-related factors were also recorded and submitted to multiple logistic regression analysis to determine the relationship of these factors to nausea and vomiting.ResultsThe incidences of nausea and vomiting from 0 to 24 h after anesthesia were 40 and 22 %, respectively. The incidences 24–48 h after anesthesia were 10 and 3 %, respectively. Female sex, previous history of PONV, prolonged anesthesia, and remifentanil use during surgery were identified as risk factors for both nausea and vomiting. The use of a volatile anesthetic, use of fentanyl during surgery, postoperative use of opioids, nonsmoking status, and drinking alcohol on 4 or fewer days per week were identified as risk factors for nausea alone.ConclusionThe incidence of and risk factors for PONV at a Japanese cancer center according to this study are comparable to those reported elsewhere.

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

Abstract: Omission of fentanyl during sevoflurane anesthesia, combined with diclofenac and local infiltration anesthesia, decreases the incidences of postoperative nausea and vomiting and accelerates postanesthesia recovery in patients undergoing major breast cancer surgery.

Cited by 25 publications

References 25 publications

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients

Results of a major ambulatory oral surgery program using general inhalational anesthesia on disabled patients

The impact of remifentanil on incidence and severity of postoperative nausea and vomiting in a university hospital-based ambulatory surgery center: a retrospective observation study

Incidence of and risk factors for postoperative nausea and vomiting at a Japanese Cancer Center: first large-scale study in Japan

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