Alfentanil May Reduce Early Postoperative Nausea and Vomiting in Moderate-to-High Risk Patients Undergoing...

Area of Science:

• Anesthesiology
• Gastroenterology
• Pharmacology

Background:

• Postoperative nausea and vomiting (PONV) is a common adverse effect following sedation for gastrointestinal endoscopy.
• Opioid selection can influence the incidence and severity of PONV.
• Patients at moderate-to-high risk require careful consideration of anesthetic agents to minimize PONV.

Purpose of the Study:

• To compare the efficacy of alfentanil versus sufentanil in preventing PONV in patients undergoing sedated gastrointestinal endoscopy.
• To evaluate the impact of these opioids on early recovery and hemodynamic stability.

Main Methods:

• A randomized trial involving 218 patients receiving either alfentanil or sufentanil combined with propofol.
• Primary outcome: PONV incidence within 24 hours postoperatively.
• Secondary outcomes: PONV in the post-anesthesia care unit (PACU), hemodynamic profiles, induction/recovery times, and adverse events.

Main Results:

• No significant difference in 24-hour PONV incidence between alfentanil and sufentanil groups (0.95% vs. 3.85%).
• Alfentanil group showed significantly lower PONV incidence (0.95% vs. 7.69%) and scores during PACU stay.
• Alfentanil was associated with shorter induction time and more stable hemodynamics.

Conclusions:

• Alfentanil may reduce early PONV and improve induction speed compared to sufentanil in sedated endoscopy.
• Alfentanil appears to be a favorable option for efficient sedation with comparable safety profiles.
• Further large-scale trials are needed to confirm these preliminary findings.