Incidence of postoperative nausea and vomiting following gynecological laparoscopy: A comparison of standard anesthetic technique and propofol infusion

Objective

To determine the safety, efficacy, and feasibility of propofol-based anesthesia in gynecological laparoscopies in reducing incidences of postoperative nausea and vomiting compared to a standard anesthesia using thiopentone/isoflurane.

Design

Randomized single-blind (for anesthesia techniques used) and double-blind (for postoperative assessment) controlled trial.

Setting

Operation theater, postanesthesia recovery room, teaching hospital.

Patients

Sixty ASA (American Society of Anesthesiologists) I and II female patients (aged 20–60 years) scheduled for gynecological laparoscopy were included in the study.

Interventions

Patients in Group A received standard anesthesia with thiopentone for induction and maintenance with isoflurane–fentanyl, and those in Group B received propofol for induction and maintenance along with fentanyl. All patients received nitrous oxide, vecuronium, and neostigmine/glycopyrrolate. No patient received elective preemptive antiemetic, but patients did receive it after more than one episode of vomiting.

Measurements

Assessment for incidence of postoperative nausea and vomiting as well as other recovery parameters were carried out over a period of 24 hours.

Main Results

Six patients (20%) in Group A and seven patients (23.3%) in Group B experienced nausea. Two patients (6.66%) in Group B had vomiting versus 12 (40%) in Group A (p < 0.05). Overall, the incidence of emesis was 60% and 30% in Groups A and B, respectively (p < 0.05). All patients in Group B had significantly faster recovery compared with those in Group A. No patient had any overt cardiorespiratory complications.

Conclusion

Propofol-based anesthesia was associated with significantly less postoperative vomiting and faster recovery compared to standard anesthesia in patients undergoing gynecological laparoscopy.