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, Risa; Hirota, Kiichi; Sato, Masami; Tanabe, Hiroko; Yazawa, Tomoko; Habara, Toshie; Fukuda, Kazuhiko

doi:10.4097/kjae.2013.65.2.142

Cited by 12 publications

(6 citation statements)

References 11 publications

(21 reference statements)

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“…There was no inter-group difference in the incidence of PONV in this study, even though the dose of intraoperative remifentanil in the TIVA + PECSB group was significantly lower than that in the TIVA group. Some studies indicated that doses of both fentanyl and remifentanil during surgery were risk factors for PONV [ 9 , 10 ], but other studies showed that intraoperative remifentanil dose did not correlate with the severity of PONV [ 11 , 12 ]. This study suggests that intraoperative dose of remifentanil may not affect the incidence of PONV.…”

Section: Resultsmentioning

confidence: 99%

Pectoral nerve block combined with general anesthesia for breast cancer surgery: a retrospective comparison

et al. 2015

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BackgroundAcute postoperative pain is an integral risk factor in the development of chronic pain after breast cancer surgery (BCS). Pectoral nerve block (PECSB) has been recently reported as an analgesic method for BCS. Here, we retrospectively compared intraoperative opioid requirement, postoperative pain after BCS, and incidence of postoperative nausea and vomiting (PONV) in patients who underwent BCS under total intravenous anesthesia (TIVA) with or without PECSB.FindingsWe reviewed anesthesia charts and medical records of 146 patients who underwent BCS at Niigata University Medical and Dental Hospital from January 2013 to March 2014; 36 patients were included in the TIVA group, and 35 patients were included in the TIVA + PECSB group. Intraoperative remifentanil requirements were significantly lower in the TIVA + PECSB group than in the TIVA group, and the cumulative distribution of remifentanil was reduced in patients who received PECSB (TIVA: 10.9 ± 2.9 μg/kg/h; TIVA + PECSB: 7.3 ± 3.3 μg/kg/h; p < 0.001). Postoperative pain scores during the 48 h after surgery were significantly lower in the TIVA + PECSB group than in the TIVA group (TIVA: 2 [1–5]; TIVA + PECSB: 1 [0–5]; p = 0.03). However, administration of fentanyl during operation, percentage of patients requiring supplemental analgesics, and incidence of PONV were not significantly different between groups.ConclusionsPECSB significantly reduced intraoperative remifentanil usage and postoperative pain. However, the requirement for postoperative supplemental analgesics and the incidence of PONV did not differ. These data suggested that PECSB may be useful for perioperative pain management in patients undergoing BCS.

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Section: Resultsmentioning

confidence: 99%

Pectoral nerve block combined with general anesthesia for breast cancer surgery: a retrospective comparison

et al. 2015

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“…Lenz et al [ 43 ] reported that intraoperative remifentanil at high doses (0.3–0.5 µg/kg/min) increased postoperative pain and morphine consumption. Another study reported that remifentanil did not increase the frequency of PONV or the use of analgesics after ambulatory surgery [ 44 ].…”

Section: Intraoperative Anesthetic Managementmentioning

confidence: 99%

Anesthesia for ambulatory surgery

Lee

2017

Korean J Anesthesiol

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Ambulatory anesthesia allows quick recovery from anesthesia, leading to an early discharge and rapid resumption of daily activities, which can be of great benefit to patients, healthcare providers, third-party payers, and hospitals. Recently, with the development of minimally invasive surgical techniques and short-acting anesthetics, the use of ambulatory surgery has grown rapidly. Additionally, as the indications for ambulatory surgery have widened, the surgical methods have become more complex and the number of comorbidities has increased. For successful and safe ambulatory anesthesia, the anesthesiologist must consider various factors relating to the patient. Among them, appropriate selection of patients and surgical and anesthetic methods, as well as postoperative management, should be considered simultaneously. Patient selection is a particularly important factor. Appropriate surgical and anesthetic techniques should be used to minimize postoperative complications, especially postoperative pain, nausea, and vomiting. Patients and their caregivers should be fully informed of specific care guidelines and appropriate responses to emergency situations on discharge from the hospital. During this process, close communication between patients and medical staff, as well as postoperative follow-up appointments, should be ensured. In summary, safe and convenient methods to ensure the patient's return to function and recovery are necessary.

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“…Dexmedetomidine: Dexmedetomidine is an α-2-adrenoceptor agonist with sedative, anxiolytic, sympatholytic, and analgesicsparing effects while causing minimal depression of respiratory function (Figure 1) [33][34][35][36]. Hemodynamic effects include transient hypertension, bradycardia, and hypotension.…”

Section: Center (Asc)mentioning

confidence: 99%

“…Therefore, it was not practical in bolus application and should only be employed by pump infusion. It was highly suitable for outpatient spine surgery [36].…”

Section: Center (Asc)mentioning

confidence: 99%

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Anesthesia For Endoscopic Spine Surgery Of The Spine In An Ambulatory Surgery Center

Abrão¹,

Dowling

León

et al. 2020

GJAPM

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Background: Providing adequate anesthesia that caters to rapid turn-over in an outpatient ambulatory surgery center setting is sometimes as much of an art as it is a science. Outpatient spine surgery is characterized by shorter simplified versions of their inpatient counterparts carried out in a hospital setting. Objective:The monitored anesthesia care (MAC) and deep sedation with a laryngeal mask airway (LMA) in the prone position have received little attention in the anesthesia and spine surgery literature. The authors reviewed their clinical outcomes with the outpatient endoscopic spinal surgery in conjunction with these two types of anesthesias. Methods:We performed an analysis of perioperative anesthesia and clinical outcomes in 184 patients who underwent lumbar endoscopic spinal surgery in two outpatient ambulatory surgery centers. The 184 patients consisted of 90 (48.9%) women and 94 (51.1%) men with an average age of 54.3 ± 15.4 years. The average follow-up of 43.27 months. The primary clinical outcome measures were the modified Macnab criteria. Chi-square testing was employed to analyze statistically significant associations between the type of anesthesia, preoperative diagnosis, the surgical level(s), and surgeon requirements for MAC versus balanced general anesthesia.Results: At the final follow-up, the majority of patients had Excellent (93/184; 50.5%) and Good (74/184; 40.2%) Macnab outcomes regardless of treatment and anesthesia. There was minimal blood loss in all patients, and there were no complications such as dural tears, or hematomas. There were also no wound problems such as bleeding, or leaking of endoscopic irrigation fluid from the wound. Of the 184 study patients, 40 patients (21.7%) had a postoperative irritation of the dorsal root ganglion (DRG). The mean anesthesia time was 37 ± 9 minutes in patients under balanced general anesthesia. with LMA and 48 ± 12 minutes in MAC patients. All of the 184 patients were discharged under one hour from the PACU after an uneventful wakeup. Only six patients (3.26%) had postoperative nausea.Conclusions: Monitored anesthesia care with sedation in an ambulatory surgery center in the prone position is best suited for endoscopic spinal decompressions. Intubation of the patient with general anesthesia is generally not required. Most patients can be managed with a nasal cannula, face mask, or a balanced general anesthesia with a laryngeal mask airway (LMA).

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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

Cited by 12 publications

References 11 publications

Pectoral nerve block combined with general anesthesia for breast cancer surgery: a retrospective comparison

Pectoral nerve block combined with general anesthesia for breast cancer surgery: a retrospective comparison

Anesthesia for ambulatory surgery

Anesthesia For Endoscopic Spine Surgery Of The Spine In An Ambulatory Surgery Center

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