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Effect of remifentanil on postoperative nausea and vomiting: a randomized pilot study

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Abstract

Opioid-related postoperative nausea and vomiting should not occur following remifentanil administration because of its relatively short time to elimination. However, studies have indicated that the incidence of postoperative nausea and vomiting associated with remifentanil is similar to that with other opioids. Hence, we aimed to determine whether intraoperative remifentanil itself is associated with postoperative nausea and vomiting when postoperative pain is managed without opioid use. In this prospective pilot study, 150 patients who underwent unilateral upper limb surgery under general anesthesia with brachial plexus block were included. Patients in the remifentanil and control groups received 0.5 µg/kg/min remifentanil and saline, respectively. Postoperative pain was managed using a brachial plexus block, non-steroidal anti-inflammatory drugs, and acetaminophen. The presence of postoperative nausea and vomiting within the first 24 h after anesthesia was assessed by an evaluator blinded to patient allocation. Eight patients were excluded from the final analysis, resulting in 72 and 70 patients in the remifentanil and control groups, respectively. Postoperative nausea and vomiting within 24 h after surgery occurred in 11 and 9 patients in the remifentanil and control groups, respectively. These data suggest that remifentanil use only minimally affects the incidence of postoperative nausea and vomiting under sevoflurane anesthesia.

UMIN Clinical Trials Registry identification number: UMIN000016110.

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Acknowledgements

Assistance with the study: we thank Dr Takahiro Tanaka (Department of Quality Control, Niigata University Medical and Dental Hospital Clinical and Translational Research Centre, Niigata, Japan) for providing technical assistance with the statistical analysis.

Funding

No external funding was received for the present study.

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Authors and Affiliations

  1. Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan

    Tatsunori Watanabe

  2. Niigata Hand Surgery Foundation, Seiro, Japan

    Tatsunori Watanabe, Koji Moriya & Naoto Tsubokawa

  3. Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Hiroshi Baba

Authors
  1. Tatsunori Watanabe
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  2. Koji Moriya
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  3. Naoto Tsubokawa
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  4. Hiroshi Baba
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Corresponding author

Correspondence to Tatsunori Watanabe.

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The author(s) declare that they have no conflict of interest.

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Watanabe, T., Moriya, K., Tsubokawa, N. et al. Effect of remifentanil on postoperative nausea and vomiting: a randomized pilot study. J Anesth 32, 781–785 (2018). https://doi.org/10.1007/s00540-018-2550-4

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  • DOI: https://doi.org/10.1007/s00540-018-2550-4

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