The effect of multimodal approach with combination of antiemetics and total intravenous anesthesia on postoperative nausea and vomiting in very high-risk patients

Hwang, Hee Youn; Kim, Eun Jin; Yang, Mi Kyung; Kim, Jie Ae; Kang, Jin Gu; Kim, Tae Hyeong; Song, Hye Won

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2010;5(1):45-49.
Published online January 30, 2010.

The effect of multimodal approach with combination of antiemetics and total intravenous anesthesia on postoperative nausea and vomiting in very high-risk patients

Hee Youn Hwang, Eun Jin Kim, Mi Kyung Yang, Jie Ae Kim, Jin Gu Kang, Tae Hyeong Kim, Hye Won Song

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. gil519.kim@samsung.com

Abstract

BACKGROUND
Postoperative nausea and vomiting (PONV) is a long standing problem in both surgical patients and anesthesiologists, and the treatment of this problem is very important.The purpose of this study was to evaluate the effect of multimodal approach with combination of antiemetics and total intravenous anesthesia (TIVA) on PONV in very high risk patients identified by the Korean predictive model.
METHODS
Between March 2008 and February 2009, we evaluated 96 patients who were considered to be at very high risk of PONV according to the Korean predictive model.Among the patients, those who received antiemetic combination of dexamethasone and ondansetron were allocated to treatment group (T) and, those who underwent operation without antiemetics were placed in control group (C).All patients were anesthetized using propofol and remifentanil.We evaluated the incidences of PONV in two groups during the first 24 hours after surgery.
RESULTS
The overall incidence of PONV was 14 (29.17%) in C group and 4 (8.33%) in T group, respectively (P = 0.027).
CONCLUSIONS
The overall incidence of PONV in T group was significantly lower than that of C group.This study shows that multimodal approach with combination of antiemetics and TIVA was effective in preventing PONV in patients with very high risk.

Key Words: Antiemetics, Postoperative nausea and vomiting, Total intravenous anesthesia