Propofol vs isoflurane anesthesia-incidence of PONV in patients at maxillofacial surgery

Gecaj-Gashi, Agreta; Hashimi, M.; Sada, F.; Baftiu, N.; Salihu, Sydha; Terziqi, H; Bruqi, B.

doi:10.2478/v10039-010-0033-4

Cited by 21 publications

(19 citation statements)

References 23 publications

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“…Although the TIVA group showed lower incidences of nausea, retching, and vomiting, and less VNRS at postoperative 6-48 hours compared to the Des group, no significant difference was observed between the two anesthetic methods after postoperative 6 hours. Our results are in agreement with a recent study,29 in which TIVA with propofol was shown to exert a preventive effect on PONV at early postoperative periods (0-6 hours) compared to isoflurane. As the antiemetic effect of propofol was shown to be maintained further beyond 2 hours postoperatively in both investigations, these results could provide evidence for the early antiemetic effect of propofol.…”

Section: Discussionsupporting

confidence: 93%

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

et al. 2012

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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.

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Section: Discussionsupporting

confidence: 93%

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

et al. 2012

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“…45 As PONV and postoperative pain are major determinants of patient dissatisfaction, 13,14 propofol TIVA has the potential to improve patients' perception of the quality of postoperative recovery. In fact, studies investigating the quality of recovery reported better outcomes for propofol TIVA compared to desflurane, 46,47 isoflurane, 48 and sevoflurane. 49,50 Schraag et al confirmed these results in a meta-analysis of 10 trials with 924 patients.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Propofol (Diprivan) Versus Inhalational Anesthetics to Maintain General Anesthesia in Noncardiac Surgery in the United States

et al. 2021

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It is not known whether using propofol total intravenous anaesthesia (TIVA) to reduce incidence of postoperative nausea and vomiting (PONV) is cost-effective. We assessed the economic impact of propofol TIVA versus inhalational anesthesia in adult patients for ambulatory and inpatient procedures relevant to the US healthcare system.Methods: Two models simulate individual patient pathways through inpatient and ambulatory surgery with propofol TIVA or inhalational anesthesia with economic inputs from studies on adult surgical US patients. Efficacy inputs were obtained from a meta-analysis of randomized controlled trials. Probabilistic and deterministic sensitivity analyses assessed the robustness of the model estimates.Results: Lower PONV rate, shorter stay in the post-anesthesia care unit, and reduced need for rescue antiemetics offset the higher costs for anesthetics, analgesics, and muscle relaxants with propofol TIVA and reduced cost by 11.41 6 10.73 USD per patient in the inpatient model and 11.25 6 9.81 USD in the ambulatory patient model. Sensitivity analyses demonstrated strong robustness of the results.Conclusions: Maintenance of general anesthesia with propofol was cost-saving compared to inhalational anesthesia in both inpatient and ambulatory surgical settings in the United States. These economic results support current guideline recommendations, which endorse propofol TIVA to reduce PONV risk and enhance postoperative recovery.

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“…A number of well-designed trials with controversial results about the prevention of PONV with a subhypnotic dose of Propofol have been published. [ 28 29 30 31 ] Shinn et al ., in a randomized clinical trial of 38 patients who underwent gynecologic laparoscopic surgery, reported that the incidence of PONV during the first 24 h postoperatively in the case of Propofol was significantly lower than that with Sevoflurane, and this corresponds to the results of the present study which have established the antiemetic effect of Propofol. But while the number of patients with PONV within 1 h postoperatively in the case of Propofol was significantly less than with Sevoflurane, there were differences in the number of patients with symptoms of PONV from 1 to 6 h and also from 6 to 24 h postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Prevention of postoperative nausea and vomiting with a subhypnotic dose of Propofol in patients undergoing lower abdominal surgery: A prospective, randomized, double-blind study

et al. 2015

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Background:Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia in patients undergoing elective lower abdominal surgery. We aimed to compare the effect of a sub hypnotic dose of Propofol in the prevention of PONV after lower abdominal surgery with that of the conventional antiemetic drug Metoclopramide.Materials and Methods:In this prospective, randomized, double-blind, placebo-controlled study, 104 patients with American Society of Anesthesiologists (ASA) class I or II status, aged 18–65 years, and undergoing elective lower abdominal surgery were randomized to one of four groups (n = 26 each). The patients in the four groups were administered intravenously Propofol 20 mg (G1), Propofol 30 mg (G2), Metoclopramide 10 mg (G3), and placebo (G4), 15 min before skin closure. All episodes of PONV during the first 24 h after anesthesia were recorded by an investigator who was blinded to treatment assignment.Results:There were no significant differences between the treatment groups with regard to their gender, age, ASA class, duration of surgery, duration of recovery time and hospital stay, and also body mass index (BMI) (P > 0.05). The prevalence of PONV 0-6 h after anesthesia was 23.08% with Propofol 20 mg (P = 0.005), 15.38% with Propofol 30 mg (P = 0.016), 15.38% with Metoclopramide 10 mg (P = 0.016), compared to 30.77% with placebo (P = 0.005).Conclusions:Administration of a subhypnotic dose of Propofol (30 mg) was found to be as effective as 10 mg Metoclopramide in reducing the incidence and severity of PONV in adult patients undergoing elective lower abdominal surgeries under Isoflurane-based anesthesia in the early postoperative period.

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Propofol vs isoflurane anesthesia-incidence of PONV in patients at maxillofacial surgery

Cited by 21 publications

References 23 publications

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

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

Cost-Effectiveness of Propofol (Diprivan) Versus Inhalational Anesthetics to Maintain General Anesthesia in Noncardiac Surgery in the United States

Prevention of postoperative nausea and vomiting with a subhypnotic dose of Propofol in patients undergoing lower abdominal surgery: A prospective, randomized, double-blind study

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