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Nausea and vomiting following thyroid and parathyroid surgery
J M Sonner1, J M Hynson, O Clark
1Department of Anesthesia, University of California, San Francisco School of Medicine 94115, USA.
Journal of Clinical Anesthesia
|August 1, 1997
Summary
Postoperative nausea and vomiting (PONV) is common after thyroid and parathyroid surgery. Propofol anesthesia significantly reduced PONV in women compared to isoflurane, despite higher costs.
Area of Science:
- Anesthesiology
- Surgical Outcomes
- Pharmacoeconomics
Background:
- Postoperative nausea and vomiting (PONV) is a frequent complication following endocrine surgeries.
- Anesthetic choices may influence PONV incidence and associated healthcare costs.
Purpose of the Study:
- To determine the incidence of PONV after thyroid and parathyroid surgery.
- To compare PONV rates between propofol and isoflurane for anesthesia maintenance.
- To evaluate the cost-effectiveness of these anesthetic regimens.
Main Methods:
- A randomized, prospective study was conducted with 118 adult patients undergoing elective thyroid or parathyroid surgery.
- Anesthesia maintenance involved either isoflurane or propofol, with all patients receiving propofol for induction.
- PONV was assessed over 24 hours postoperatively; prophylactic antiemetics were not used.
Main Results:
- The overall incidence of PONV was 54%.
- Propofol significantly reduced PONV compared to isoflurane (44% vs. 64%, p<0.05), particularly in women (42% vs. 71%, p<0.05).
- No significant differences were observed in hospital stay or wound complications; propofol incurred an additional cost of $54.26 per patient.
Conclusions:
- Thyroid and parathyroid surgery patients face a high risk of PONV.
- Propofol anesthesia is more effective in reducing PONV in women undergoing these procedures than isoflurane.
- Despite increased cost, propofol may be considered for PONV reduction in susceptible patient populations.