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Effect of Dexmedetomidine Compared to Remifentanil During Bariatric Surgery on Postoperative Nausea and Vomiting: a Retrospective Study

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Abstract

Purpose

Postoperative nausea and vomiting (PONV) occurs frequently after bariatric surgery and is a major cause of adverse outcomes. This retrospective study investigated whether opioid-restricted total intravenous anesthesia using dexmedetomidine as a substitute for remifentanil can reduce PONV in bariatric surgery.

Materials and Methods

The electronic medical records of adult patients who underwent laparoscopic bariatric surgery between January and December 2019 were reviewed. The patients were divided into two groups according to the agents used for anesthesia: Group D, propofol and dexmedetomidine; Group R, propofol and remifentanil.

Results

A total of 134 patients were included in the analyses. The frequency of postoperative nausea was significantly lower in Group D than that in Group R until 2 h after discharge from the postanesthesia care unit (PACU) (P = 0.005 in the PACU, P = 0.010 at 2 h after PACU discharge) but failed to significantly reduce the overall high incidence rates of 60.5% and 65.5%, respectively (P = 0.592). Postoperative pain score was significantly lower in Group D until 6 h after PACU discharge. The rates of rescue antiemetic and analgesic agent administration in the PACU were significantly lower in Group D than those in Group R.

Conclusion

Opioid-restricted total intravenous anesthesia using dexmedetomidine reduces postoperative nausea, pain score, antiemetic, and analgesic requirements in the immediate postoperative period after bariatric surgery.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 13620, Gumi-ro 137-82, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea

    Sun Woo Nam, Ah-Young Oh, Bon-Wook Koo, Bo Young Kim, Jiwon Han & Jiwon Yoon

  2. Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

    Ah-Young Oh

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  1. Sun Woo Nam
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The authors have contributed equally to this work.

Corresponding author

Correspondence to Ah-Young Oh.

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All procedures in this study were performed in accordance with the ethical standards of the institutional and/or national research committee, the 1964 Declaration of Helsinki and its later amendments, and/or comparable ethical standards.

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Key Points

• The incidence of postoperative nausea following bariatric surgery is very high.

• Opioid-restricted anesthesia using dexmedetomidine reduces postoperative nausea.

• Opioid-restricted anesthesia using dexmedetomidine reduces postoperative pain score.

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Nam, S.W., Oh, AY., Koo, BW. et al. Effect of Dexmedetomidine Compared to Remifentanil During Bariatric Surgery on Postoperative Nausea and Vomiting: a Retrospective Study. OBES SURG 32, 3368–3374 (2022). https://doi.org/10.1007/s11695-022-05894-4

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