This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yang, H. Articles by Buckley, N. Search for Related Content PubMed PubMed Citation Articles by Yang, H. Articles by Buckley, N.

Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery

[L’induction avec sévoflurane-rémifentanil ou propofol-fentanyl rocuronium est similaire quant aux NVPO en chirurgie laparoscopique]

Homer Yang, MD FRCPC^*, Peter T.-L. Choi, MD FRCPC^,, James McChesney, MB CHB FRCPC and Norman Buckley, MD FRCPC^*

^* From the Departments of Anesthesia, Hamilton Health Sciences, and
St. Joseph’s Healthcare; and
the Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.

Address correspondence to: Dr. Norman Buckley, McMaster University, Department of Anesthesia, 1200 Main Street West, Room HSC-2U1, Hamilton, Ontario L8N 3Z5, Canada. Phone: 905-521-2100, ext. 75166; Fax: 905-523-1224; E-mail: buckleyn{at}mcmaster.ca

Purpose: To compare sevoflurane-remifentanil induction and propofol-fentanyl-rocuronium induction with regards to the frequency of moderate to severe postoperative nausea and vomiting (PONV) in the first 24 hr after laparoscopic day surgery.

Methods: After informed consent, 156 ASA physical status class I to III patients undergoing laparoscopic cholecystectomy or tubal ligation were randomized to either induction with sevoflurane 8%, N₂O 67% and iv remifentanil 1 to 1.5 µg·kg^–1 or induction with iv fentanyl 2 to 3 µg·kg^–1, propofol 2 mg·kg^–1, and rocuronium 0.3 to 0.5 mg·kg^–1. All patients received iv ketorolac 0.5 mg·kg^–1 at induction and sevoflurane-N₂O maintenance anesthesia with rocuronium as needed. PONV was treated with iv ondansetron, droperidol, or dimenhydrinate; postoperative pain was treated with opioid analgesics. Patients were followed for 24 hr with regards to PONV and pain. Intubating conditions, induction and emergence times, time to achieve fast-track discharge criteria, and drug costs were measured.

Results: No differences were seen between the two groups in their frequencies of 24-hr moderate to severe PONV and postoperative pain, or in their intubating conditions, induction and emergence times, and time to achieve fast-track discharge criteria. Patients undergoing sevoflurane-remifentanil induction received more morphine (11 mg vs 8 mg; P < 0.001) in the postanesthetic care unit. Sevoflurane-remifentanil induction resulted in similar anesthetic and total drug costs for both procedures.

Conclusion: We did not demonstrate any difference in PONV, pain, or anesthetic/recovery times or costs between the sevoflurane and propofol groups. Sevoflurane-remifentanil induction is a feasible technique for anesthetic induction.

This article has been cited by other articles:

				F. Donati Evaluating intubating conditions using the GCRP recommendations Can J Anesth, March 1, 2005; 52(3): 337 - 338. [Full Text] [PDF]

				P. T.-L. Choi, H. Yang, J. McChesney, and N. Buckley REPLY Can J Anesth, March 1, 2005; 52(3): 338 - 338. [Full Text] [PDF]