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
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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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author Liu ZY
Yang XY
Lv C
Ye L
Chen JJ
Chen XY
Wang SP
Wu L
Zhang WQ
Lu M
Guo XW
author_facet Liu ZY
Yang XY
Lv C
Ye L
Chen JJ
Chen XY
Wang SP
Wu L
Zhang WQ
Lu M
Guo XW
author_sort Liu ZY
collection DOAJ
description 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
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spelling doaj-art-3908d4235cb5429eaa47bdfb4a94c0822025-08-20T03:26:57ZengDove Medical PressDrug Design, Development and Therapy1177-88812025-06-01Volume 19Issue 148854894103661Effect 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 StudyLiu ZY0Yang XY1Lv C2Ye L3Chen JJ4Chen XY5Wang SPWu L6Zhang WQLu M7Guo XW8Department of Anesthesiology, Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyScientific Research DepartmentDepartment of AnesthesiologyDepartment of AnesthesiologyZao-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, BIShttps://www.dovepress.com/effect-of-high-maintenance-dose-versus-low-dose-of-remifentanil-on-inc-peer-reviewed-fulltext-article-DDDThigh-dose remifentanilpropofolpostoperative nausea and vomitingPONVhyperalgesiabispectral index
spellingShingle Liu ZY
Yang XY
Lv C
Ye L
Chen JJ
Chen XY
Wang SP
Wu L
Zhang WQ
Lu M
Guo XW
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
Drug Design, Development and Therapy
high-dose remifentanil
propofol
postoperative nausea and vomiting
PONV
hyperalgesia
bispectral index
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic high-dose remifentanil
propofol
postoperative nausea and vomiting
PONV
hyperalgesia
bispectral index
url 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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