Total Intravenous Anesthesia with Propofol Reduces Postoperative Nausea and Vomiting in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Prospective Randomized Trial

Abstract

PurposeWe investigated the effect of total intravenous anesthesia (TIVA) with propofol on postoperative nausea and vomiting (PONV) after robot-assisted laparoscopic radical prostatectomy (RLRP) in patients at low risk of developing PONV, in comparison to balanced anesthesia with desflurane.Materials and MethodsSixty two patients were randomly assigned to the Des or TIVA group. Propofol and remifentanil were used for induction of anesthesia in both groups and for maintenance of the anesthesia in the TIVA group. In the Des group, anesthesia was maintained with desflurane and remifentanil. In both groups, postoperative pain was controlled using fentanyl-based intravenous patient controlled analgesia, and ramosetron 0.3 mg was administered at the end of surgery. The incidence of PONV, severity of nausea and pain, and requirements of rescue antiemetics and analgesics were recorded.ResultsThe incidence of nausea in the post-anesthetic care unit was 22.6% in the Des group and 6.5% in the TIVA (p=0.001) group. The incidence of nausea at postoperative 1-6 hours was 54.8% in the Des group and 16.1% in the TIVA group (p=0.001). At postoperative 6-48 hours, there were no significant differences in the incidence of nausea between groups.ConclusionIn order to prevent PONV after RLRP in the early postoperative period, anesthesia using TIVA with propofol is required regardless of patient-related risk factors.

Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis

“…A total of 13 trials reported pain intensity at or around 2 h postsurgery, in which 686 patients received anaesthesia using propofol for maintenance, while 668 were given inhalational anaesthesia [10,11,[18][19][20][21][22][23][24][25][26][27][28]. Overall, pain scores were not significantly different between experimental groups (Hedge's g (95%CI) À0.120 (À0.415-0.175) (p = 0.425) (Fig.…”

“…A total of nine trials reported pain intensity at or around 24 h postsurgery, in which 595 patients received propofol anaesthesia, while 586 had inhalational anaesthesia [10,11,18,19,21,22,25,28,29]. Overall, compared with inhalational anaesthetics, patients who received propofol reported significantly lower pain scores 24 h postsurgery (Hedge's g (95% CI) À0.134 (À0.248 to À0.021) (p = 0.021) (Fig.…”

“…Eight studies investigated postoperative nausea and vomiting, with 371 patients receiving propofol and 354 patients receiving inhalational anaesthesia [10,19,20,22,24,25,28,30]. Propofol was associated with a significant reduction in postoperative nausea and vomiting (relative risk (95% CI) 0.446 (0.304-0.656) (p < 0.0001) (Fig.…”

Avaliação eletrocardiográfica de macacos-prego (Sapajus apella) sob contenção química com midazolam e propofol

“…Segundo um estudo realizado em macacos da espécie Macaca mulatta, demonstrou que o tempo de recuperação anestésica após contenção química utilizando propofol (6mg/kg/IV) foi de 22,5 ± 3,2 minutos, ligeiramente inferior quando comparado à associação cetamina (8mg/kg/IM) midazolam (0,2 mg/kg/IM), que durou 41,2 ± 5,9 minutos. O propofol tem sido amplamente utilizado em protocolos de anestesia intravenosa, sendo seu uso muito difundido na Medicina Veterinária e humana (SUAREZ et al, 2012, YOO et al, 2012.…”

Comparison of the Impact of Propofol and Sevoflurane on Early Postoperative Recovery in Living Donors After Laparoscopic Donor Nephrectomy: A Prospective Randomized Controlled Study

“…In this trial, the highest NRS pain score for the wound site was slightly, but non-signi cantly, lower in the IV propofol group, both during coughing and at rest. Thirdly, propofol signi cantly reduces PONV compared with inhalational anesthetics (25). The anti-emetic effect of propofol is associated with inhibition of the 5-hydroxy-tryptamine-3 (5-HT) receptors in the serotonergic system, dopaminergic (D2) receptors in the chemoreceptor trigger zone, and the limbic system (22,26).…”