Pradipta Bhakta1, Bablu Rani Ghosh2, Umesh Singh3, Preeti S Govind4, Abhinav Gupta4, Kulwant Singh Kapoor5, Rajesh Kumar Jain6, Tulsi Nag2, Dipanwita Mitra7, Manjushree Ray8, Vikash Singh9, Gauri Mukherjee10. 1. Department of Anesthesiology and Intensive Care, University Hospital Kerry, Tralee, Ireland. Electronic address: bhaktadr@hotmail.com. 2. Department of Anaesthesia and Intensive Care, Ramakrishna Mission Seva Pratishthan, Calcutta, India. 3. Department of Internal Medicine, Division of Immunology/Allergy, University of Cincinnati, College of Medicine, Cincinnati, OH, USA. 4. Department of Anaesthesia and Pain Management, Indian Spinal Injuries Centre, New Delhi, India. 5. Department of Biostatistics, All Indian Institute of Medical Sciences, New Delhi, India. 6. Department of Anaesthesia and Intensive Care, Princess Royal Hospital, Apley Castle, Telford TF1 6TF, UK. 7. Department of Anaesthesia, Dr. B.C. Roy Postgraduate Institute of Paediatric Sciences, Calcutta, India. 8. Calcutta National Medical College, Kolkata, India. 9. Department of Anaesthesia and Intensive Care, St. James University Hospital, Dublin, Ireland. 10. Department of Anaesthesia, Calcutta National Medical College, Calcutta, India.
Abstract
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.
RCT Entities:
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.
Authors: Yuwen Chen; Yiziting Zhu; Kunhua Zhong; Zhiyong Yang; Yujie Li; Xin Shu; Dandan Wang; Peng Deng; Xuehong Bai; Jianteng Gu; Kaizhi Lu; Ju Zhang; Lei Zhao; Tao Zhu; Ke Wei; Bin Yi Journal: Front Med (Lausanne) Date: 2022-09-14