Post-operative Nausea and Vomiting in Out-Patient Gynecologic Laparoscopy : A Comparison of Thiopental - Nitrous Oxide, Propofol - Nitrous Oxide and Total Intravenous Anesthesia Using Propofol
LAKSAMEE CHANVEJ, M.D.*' SIRIKUL KIJSIRIKUL, M.D.**'
PARAMEE THONGSUKSAI, M.D.***' LAEAD NAHEEM, RN*
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Prince of Songk.la University, Songkhla 90110,
** Department of Anesthesiology, Rajvithi Hospital, Bangkok 10400,
*** Department of Pathology, Faculty of Medicine, Prince of Songk.la University, Songkhla 90110, Thailand.
AbstractAn intravenous anesthetic drug, propofol was considered to pose antiemetic action. A
randomized controlled trial was conducted to evaluate whether propofol could effectively reduce
post-operative nausea and vomiting (PONV) compared to thiopental - nitrous oxide (Np). One
hundred and eight patients undergoing outpatient gynecologic laparoscopy were assigned to
receive 3 techniques of anesthesia; thiopental-Np (TIN), propofol-Np (PIN) and total intra
venous anesthesia (TIV A) using propofol (PIP). The results showed that in the early period (0-5
hours), post-operative nausea in TIN, PIN and PIP groups was 72 per cent, 44 per cent and 31 per
cent, respectively (P =0.002), and post-operative vomiting was 58 per cent, 36 per cent and 11 per
cent respectively (P =0.00014). Patients in the PIN and PIP groups experienced nausea less fre
quently than the TIN group [relative risk (RR) = 0.62, (95% CI 0.41-0.93) and RR = 0.42 (0.25-
0.72) respectively]. Patients in the PIN and PIP groups experienced vomiting less frequently than
the TIN group [RR = 0.62 (0.37-1.04) and RR = 0.19 (0.07-0.5) respectively]. Two patients in the
TIN group were admitted because of severe nausea and vomiting. In conclusion, TIVA using pro
pofol and propofol-Np anesthesia can significantly reduce the incidence of PONV in the early
period. Concerning the economic crisis of the country as well as the quality of care, propofol- Np
would be the most appropriate anesthetic of choice.
Keywords : Propofol, Thiopental, Nitrous Oxide, Outpatient Gynecologic Laparoscopy, Post
operative Nausea and Vomiting
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