Effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery.

BACKGROUND We investigated the effects of a novel method of anesthesia combining propofol and volatile anesthesia on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic gynecological surgery. METHODS Patients were randomly divided into three groups: those maintained with sevoflurane (Group S, n=42), propofol (Group P, n=42), or combined propofol and sevoflurane (Group PS, n=42). We assessed complete response (no postoperative nausea and vomiting and no rescue antiemetic use), incidence of nausea and vomiting, nausea severity score, vomiting frequency, rescue antiemetic use, and postoperative pain at 2 and 24h after surgery. RESULTS The number of patients who exhibited a complete response was greater in Groups P and PS than in Group S at 0-2h (74%, 76% and 43%, respectively, p=0.001) and 0-24h (71%, 76% and 38%, respectively, p<0.0005). The incidence of nausea at 0-2h (Group S=57%, Group P=26% and Group PS=21%, p=0.001) and 0-24h (Group S=62%, Group P=29% and Group PS=21%, p<0.0005) was also significantly different among groups. However, there were no significant differences among groups in the incidence or frequency of vomiting or rescue antiemetic use at 0-24h. CONCLUSION Combined propofol and volatile anesthesia during laparoscopic gynecological surgery effectively decreases the incidence of postoperative nausea. We term this novel method of anesthesia "combined intravenous-volatile anesthesia (CIVA)".