ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
The Effects Of Sevoflurane, Isoflurane And Total Intravenous Anesthesia With Propofol On Postoperative Nause And Vomiting In Trioidectomy Surgery
Zekeriyya ALANOĞLU*, Işıl Gülay İLTAR**, Hatice EYİGÜN**, Necati ÇANAKÇI***
* Uz.Dr., Ankara Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon AD,
** Arş.Gör.Dr., Ankara Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon AD,
***Prof.Dr., Ankara Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon AD, ANKARA
Purpose: The purpose of this randomized, prospective study was to investigate the effect of sevoflurane, isoflurane and total intravenous anesthesia with propofol on postoperative nausea and vomiting in patients undergoing thyroidectomy.
Materials and Methods: One hundred and twenty seven female patients undergoing thyroidectomy were randomly allocated into three groups due to anesthesia management technique. Sevoflurane 2% and isoflurane 1.5 % were the agents for anesthesia management in group S and group I respectively. In group P propofol infusion was used 10 mg/kg/h for the first 10 minute, 8 mg /kg/h for the next 10 minute and 6 mg/kg/h for the rest of the operation period. Patients in group S and I received midazolam 0.02 mg/kg, thiopental sodium 7 mg/kg, but in group P midazolam 0.02 mg/kg and propofol 2.5 mg/kg were used for anesthesia induction. Vecuronium bromide 0.1 mg/kg was the muscle relaxant and patients were ventilated with O2 50% and N2O 50% mixture. A history of postoperative nausea and vomiting, motion sickness and the phase of the menstrual cycle were noted. Surgery and anesthesia durations were recorded. Steward and Alderete recovery scores, and Abromowitz emesis score were noted at extubation, 5, 15, 30 min. after extubation and postoperative 1st, 3rd, 6th and 24th hours. Antiemetic and analgesic medications were also noted at postoperative 24th hour. Analysis of variance, Kruskal Wallis one way ANOVA, Mann Whitney U tests and Chi square test were the statistical analysis techniques. A P value <0.05 was considered as significant.
Results: Seven patients were excluded from the study due to failure of intubation at the first attempt. The patients’ characteristics were similar except anesthesia and surgery times found longer in group I when compared to group S and P (p=0.017 and 0.034 respectively). The total antiemetic medication in group S was higher (p=0.03). The Abromowitz emesis score was found higher in group S at 1st, 3rd, 6th, and 24th hour postoperatively compared to other groups (p<0.05). Total vomiting episodes and number of patients vomited at postoperative 24th hour in group S (n=26, 65%) was higher then group I (n=12, 30 %) and P (n=14, 35 %) (p<0.05).
Conclusion: In thyroidectomy surgery, postoperative nausea and vomiting is found to be more frequent after sevoflurane based anesthesia, compared to isoflurane or propofol.Keywords: Thyroidectomy, Isoflurane, Methyl Ethers , Propofol, VomitingTurkiye Klinikleri J Med Sci 2003, 23:378-385
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