Post-Thyroidectomy Nausea and Vomiting Using Continuous Remifentanil Infusion During Emergence Depending on the Inhaled Anesthetics: A Retrospective Cohort Study.

Background and

Objectives

Immediately after thyroidectomy, retching driven by postoperative nausea and vomiting (PONV) may cause wound rupture, severe bleeding, and airway obstruction. Although inhaled anesthetics are widely used in thyroidectomy, they may increase the postoperative risk of PONV. Therefore, this study aimed to compare PONV incidence and recovery patterns according to the characteristics of sevoflurane (Sevo) and desflurane (Des) when remifentanil was continuously infused until extubation. Materials and

Methods

This retrospective cohort study involved 70 female patients undergoing elective thyroidectomy, who were categorized into the Sevo (n = 35) and Des (n = 35) groups. Remifentanil was administered at an effect-site concentration of 2 ng/mL during emergence.

Results

PONV incidence during emergence was 20% in both groups (p = 1.000). The Des group had shorter times to recovery of consciousness and extubation than the Sevo group (p < 0.001 and p < 0.001, respectively). At 5 min after extubation, patients in the Des group were more alert (p = 0.001), with 54.3% awake and responsive. Postanesthesia care unit stay was also shorter in the Des group (16.89 ± 3.22 vs. 23.74 ± 4.80; p < 0.001). Additionally, perioperative hemodynamic status, surgical site pain, and residual sedation did not differ between inhaled anesthetics.

Conclusions

When remifentanil was infused until extubation after thyroidectomy, the choice of inhaled anesthetics did not affect the incidence of acute PONV. Des provided faster early recovery without additional side effects than Sevo; nonetheless, acute recovery profiles did not differ between inhaled anesthetics.