Effect of High Maintenance Dose Versus Low Dose of Remifentanil on Incidence of Postoperative Nausea and Vomiting (PONV) in Patients Under Gynecological Laparoscopic Procedure: A Pilot Study

Zao-Yu Liu,* Xin-Yu Yang,* Chen Lv, Ling Ye, Jia-Jia Chen, Xin-Yuan Chen, Shi-Ping Wang, Li Wu, Wei-Qiao Zhang, Man Lu, Xiao-Wen Guo Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Med...

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Main Authors: Liu ZY, Yang XY, Lv C, Ye L, Chen JJ, Chen XY, Wang SP, Wu L, Zhang WQ, Lu M, Guo XW
Format: Article
Language:English
Published: Dove Medical Press 2025-06-01
Series:Drug Design, Development and Therapy
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Online Access:https://www.dovepress.com/effect-of-high-maintenance-dose-versus-low-dose-of-remifentanil-on-inc-peer-reviewed-fulltext-article-DDDT
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Summary:Zao-Yu Liu,* Xin-Yu Yang,* Chen Lv, Ling Ye, Jia-Jia Chen, Xin-Yuan Chen, Shi-Ping Wang, Li Wu, Wei-Qiao Zhang, Man Lu, Xiao-Wen Guo Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiao-Wen Guo, Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310003, People’s Republic of China, Email guoxiaowen1315@hotmail.comPurpose: The aim of this trial was to investigate postoperative nausea and vomiting (PONV) incidence between low- and high-dose remifentanil with propofol for total intravenous anaesthesia (TIVA) in adult female patients with gynecologic laparoscopy.Patients and Methods: The randomized clinical trial consisted of two groups: 0.1ug/kg/min remifentanil (L group) (n=39) and 0.4ug/kg/min remifentanil (H group) (n=40). Both of them was titrated with propofol to maintain bispectral index (BIS) values between 40 and 60. Forty-eight-hour PONV and postoperative visual analogue scale (VAS) and haemodynamic parameters and recovery quality and the concentrations of propofol TCI during the intraoperative periods were evaluated.Results: PONV incidences at 2, 6, 24, and 48 hours were 12.5%, 15%, 20% and 20% in (H group) and 25.6%, 25.6%, 25.6%, and 25.6% in (L group), but no statistical difference between groups (all P values > 0.05). H group reduced propofol use and recovery time (6.5 ± 4.8 versus. 8.7 ± 4.4 P = 0.036) but increased norepinephrine requirements (0 (0, 8) vs 0 (0, 0) P = 0.005). PCA use and first analgesic request time were similar.Conclusion: High-dose remifentanil regimens for TIVA would not increase the incidence of PONV, however, significantly reduce the demand for propofol, and promote rapid recovery of patients.Keywords: high-dose remifentanil, propofol, postoperative nausea and vomiting, PONV, hyperalgesia, bispectral index, BIS
ISSN:1177-8881