Effect of total intravenous anaesthesia and prophylactic ramosetron on postoperative nausea and vomiting after thyroidectomy: A prospective, randomized controlled study

OBJECTIVE To investigate the effect of combined prophylactic ramosetron and total intravenous anaesthesia (TIVA) on postoperative nausea and vomiting (PONV), compared with sevoflurane anaesthesia without prophylactic antiemetics, in female patients undergoing thyroidectomy. METHODS Female patients were randomized between the sevoflurane group (anaesthesia maintained with sevoflurane) or TIVA + ramosetron group (TIVAR; 0.3 mg ramosetron just before anaesthesia induction, remifentanil and propofol anaesthesia). Incidence and severity of PONV and use of rescue antiemetics were recorded during the first 24 h after surgery. RESULTS In the early postoperative period (0-6 h), the incidence of PONV, severe emesis and rescue antiemetic use were significantly lower in the TIVAR group (n = 36) than in the sevoflurane group (n = 36). In the late postoperative period (6-24 h), the incidence of severe emesis was significantly lower in the TIVAR group than in the sevoflurane group. CONCLUSIONS A combination of TIVA and prophylactic ramosetron decreases early PONV and late postoperative severe emesis compared with sevoflurane anaesthesia.