Postoperative Nausea and Vomiting and Postoperative Pain in Patients Undergoing Elective Laparoscopy; Comparison of Total Intravenous Anesthesia versus Inhalational Anesthesia: A Randomized Clinical Trial

Abstract

Background: Two major complications of surgeries are postoperative nausea and vomiting (PONV) and also postoperative pain (POP). Several studies have compared total intravenous anesthesia (TIVA) with inhalational anesthesia regarding these two complications. Some results have shown a better postoperative recovery conditions, but other contradictory results can also be found.This study was performed to evaluate and compare the effect of inhalational and intravenous anesthesia in patients undergoing elective laparoscopic surgery, on the incidence and the severity of PONV and POP. Methods: This study was performed as a single-blinded prospective clinical trial. All patients aged 18-65, with ASA class I and II who underwent elective laparoscopy were included. Patients were divided into two groups of intravenous anesthesia and inhalational anesthesia. The incidence and the severity of PONV and POP were examined in 5 separated times after the surgery. The use of a rescue antiemetic and analgesic medication were also evaluated. Results: Overall, 67 patients received inhalational anesthesia and 55 patients received intravenous anesthesia. It was revealed that 47.8% of the patients in the inhalation group and 18.2% of the patients in the intravenous group developed PONV (P<0.001). The severity of PONV was significantly lower in the TIVA group (P<0.001), however, no statistically significant difference was found regarding the severity of abdominal pain (P=0.62). Conclusion: The incidence of PONV and the need for administration of an antiemetic rescue drug are significantly lower in the TIVA group.

Keywords

• Postoperative nausea and vomiting
• Postoperative pain
• Inhalation anesthesia
• Intravenous anesthesia
• Laparoscopy