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Comparison of the Influence of Desflurane and Sevoflurane on Postoperative Nausea, Vomiting, and Pain in Patients Receiving Opioid-Based Intravenous Patient-Controlled Analgesia after Gynecological Surgery: Propensity Score Matching Analysis

Yeon Sil Lee, Min Kyoung Kim, Geun Joo Choi, Chong Wha Baek, Yong Hun Jung, Hyun Kang

Abstract


Background: This retrospective study compared the effects of desflurane and sevoflurane on postoperative nausea and vomiting (PONV) and pain.

Materials and Methods: We reviewed the electronic medical records of 952 adults who received fentanyl-based IV-PCA after laparoscopic gynecological surgery at the Chung-Ang University Hospital between January 1, 2010, and December 31, 2015. We classified the patients into two groups— desflurane (group D; n = 527) or sevoflurane (group S, n = 425). Then, we selected 222 patients in a 1:1 ratio by the propensity score matching (PSM) method.

Results: Prior to PSM, the necessity for rescue analgesics at postoperative days 0 and 1 were lower in group S than in group D, as were the severity of NRS scores for nausea and the frequency of vomiting at postoperative day 0. After PSM, the differences between the two groups were no longer statistically significant, except the severity of NRS scores for nausea. The number of patients administered rescue antiemetic at PACU was lower in group S than in group D and the frequency of complete response (CR) was significantly higher in group S than in group D at postoperative day 0.

Conclusions: In patients receiving opioid-based IV-PCA after laparoscopic gynecological surgery, sevoflurane has beneficial effect on PONV, especially in terms of rescue antiemetic at PACU and severity of nausea, CR at postoperative day 0, as compared to desflurane, but there was no difference in terms of postoperative pain.

Synthesis and applications: Sevoflurane has beneficial effect on PONV in patients receiving opioid-based IV-PCA after laparoscopic gynecological surgery.

 

Keywords : analgesia, patient-controlled; pain, postoperative; postoperative nausea and vomiting; volatile anesthetic

Keywords


analgesia, patient-controlled; pain, postoperative; postoperative nausea and vomiting; volatile anesthetic

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References


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