Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · 2026
Total Intravenous Anesthesia Versus Volatile Anesthesia in Bariatric Surgery: A Balanced Comparison of Patient-reported Pain, Postoperative Nausea and Vomiting, and Opioid Use in a Randomized Controlled Trial.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Kronström Rebecca, Bredbacka Sixten, Tomson Axel, Wirén Mikael, Hemmingsson Joanna Uddén
Аннотация
PURPOSE: Bariatric surgery is an effective treatment for obesity, but postoperative nausea and vomiting (PONV) and pain remain significant challenges despite advances in anesthesia. This study aimed to compare total intravenous anesthesia (TIVA) with volatile anesthesia regarding PONV and pain outcomes from a patient-reported perspective in bariatric surgery.
DESIGN: A randomized controlled trial comparing the effects of TIVA and volatile anesthesia on PONV and pain in bariatric surgery.
METHODS: A total of 233 bariatric patients were randomized to receive either TIVA or volatile anesthesia. Patient-reported outcomes for PONV and pain were assessed using a numeric rating scale. Additional data on medication use and time to discharge were collected. Thirty-four patients were lost to follow-up, resulting in a final analysis based on data from 199 patients.
FINDINGS: Patients receiving TIVA experienced significantly lower PONV in the postanesthesia care unit (P ≤ .001) but required significantly higher opioid doses (P = .013) and had longer postanesthesia care unit stays (P = .017) compared to those receiving volatile anesthesia. No significant differences in pain scores were observed between the groups, and no differences were found in postoperative ward outcomes.
CONCLUSIONS: TIVA reduces early PONV but increases opioid requirements compared to volatile anesthesia in bariatric surgery. These findings underscore the importance of tailored anesthetic protocols that balance early recovery benefits with opioid-related risks.
DESIGN: A randomized controlled trial comparing the effects of TIVA and volatile anesthesia on PONV and pain in bariatric surgery.
METHODS: A total of 233 bariatric patients were randomized to receive either TIVA or volatile anesthesia. Patient-reported outcomes for PONV and pain were assessed using a numeric rating scale. Additional data on medication use and time to discharge were collected. Thirty-four patients were lost to follow-up, resulting in a final analysis based on data from 199 patients.
FINDINGS: Patients receiving TIVA experienced significantly lower PONV in the postanesthesia care unit (P ≤ .001) but required significantly higher opioid doses (P = .013) and had longer postanesthesia care unit stays (P = .017) compared to those receiving volatile anesthesia. No significant differences in pain scores were observed between the groups, and no differences were found in postoperative ward outcomes.
CONCLUSIONS: TIVA reduces early PONV but increases opioid requirements compared to volatile anesthesia in bariatric surgery. These findings underscore the importance of tailored anesthetic protocols that balance early recovery benefits with opioid-related risks.