Propofol decreases early postoperative nausea and vomiting in patients undergoing thyroid and parathyroid operations

Abstract
Background  As the practice of parathyroid and thyroid surgery shifts toward short stay and outpatient treatment, the occurrence and management
of postoperative nausea and vomiting (PONV) increases in importance due to its potential to delay discharge. PONV also may
contribute negatively to the patient’s experience and thus their level of satisfaction. The purpose of this study was to determine
whether anesthetic technique based on propofol decreases the incidence of PONV and, consequently, improves patient satisfaction
with their care.

Methods  A prospective, randomized trial included patients undergoing thyroidectomy and parathyroidectomy under general anesthetic
with (75 patients) or without (73 patients) propofol. Occurrences of nausea, vomiting, and the resultant treatment were tracked
during the perioperative period. Repeated questionnaires at multiple time points determined patient expectations and experiences
related to PONV after their operation. Statistical analyses compared differences between the propofol and non-propofol groups.

Results  PONV was significantly less likely in the propofol group at the early time points (in the operating room and postanesthesia
care unit) but not at later time points (postoperative day 1 or 2). Patients were largely satisfied with different aspects
of their management despite the specifics of their anesthetic regimen.

Conclusions  A propofol-based anesthetic decreases PONV immediately after the operation but this influence does not persist throughout
the episode of care or significantly contribute to patient perceptions of satisfaction.

Content Type Journal ArticleDOI 10.1007/s00268-008-9472-5Authors
Paul G. Gauger, University of Michigan Medical School Department of Surgery, Division of Endocrine Surgery 1500 East Medical Center Drive, TC 2920D Ann Arbor MI 48109-0331 USAAmy Shanks, University of Michigan Medical School Department of Anesthesiology Ann Arbor MI 48109-0331 USAMichelle Morris, University of Michigan Medical School Department of Anesthesiology Ann Arbor MI 48109-0331 USAMary Lou V. H. Greenfield, University of Michigan Medical School Department of Anesthesiology Ann Arbor MI 48109-0331 USARichard E. Burney, University of Michigan Medical School Department of Surgery, Division of Endocrine Surgery 1500 East Medical Center Drive, TC 2920D Ann Arbor MI 48109-0331 USAMichael O’Reilly, University of Michigan Medical School Department of Anesthesiology Ann Arbor MI 48109-0331 USA

Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)