Comparison of effects of desflurane and sevoflurane on postoperative nausea, vomiting, and pain in patients receiving opioid-based intravenous patient-controlled analgesia after thyroidectomy: Propensity score matching analysis.

Abstract

In this study, we aimed to compare the effect of desflurane and sevoflurane on postoperative nausea and vomiting and pain in patients receiving opioid-based intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy.We reviewed the electronic medical records of 1042 patients administered opioid-based IV-PCA after a thyroidectomy at Chung-Ang University Hospital between January 1, 2010 and June 30, 2016. We classified the patients into 2 groups according to the inhalation anesthetic used for anesthesia: desflurane versus sevoflurane (groups D and S, n = 587 and 455, respectively). Then, propensity scoring was used to select 234 matched subjects between both groups based on their confounding factors. A propensity score matching method was used to match patients from the 2 groups in a 1:1 ratio.Before the propensity score analysis, there was no significant difference between the 2 groups. However, after the propensity score matching, the frequency of complete remission (CR, defined as no nausea and vomiting) was significantly higher in group S than it was in group D. The number of patients administered rescue antiemetics on day 0 in group S was lower than that in group D, although it was not statistically significant.In patients receiving opioid-based IV-PCA after thyroidectomy, sevoflurane seems to be more beneficial in achieving CR than desflurane was. However, further randomized controlled studies are needed to confirm this conclusion.

• Authors: Il Jae Yoon, Hyun Kang, Chong Wha Baek, Geun Joo Choi, Yong-Hee Park, Yong Hun Jung, Young Cheol Woo, Sangseok Lee
• Journal: Medicine (Medicine (Baltimore)) Vol. 96 Issue 16 Pg. e6681 (Apr 2017) ISSN: 1536-5964 [Electronic] United States
• PMID: 28422881 (Publication Type: Comparative Study, Journal Article, Observational Study)

Chemical References

• Analgesics, Opioid
• Anesthetics, Inhalation
• Methyl Ethers
• Sevoflurane
• Desflurane
• Isoflurane

Topics

• Adult
• Analgesia, Patient-Controlled (methods)
• Analgesics, Opioid (administration & dosage, therapeutic use)
• Anesthetics, Inhalation (adverse effects, therapeutic use)
• Desflurane
• Female
• Humans
• Isoflurane (adverse effects, analogs & derivatives, therapeutic use)
• Male
• Methyl Ethers (adverse effects, therapeutic use)
• Middle Aged
• Pain, Postoperative (chemically induced)
• Postoperative Nausea and Vomiting (chemically induced)
• Propensity Score
• Sevoflurane
• Thyroidectomy (adverse effects, methods)