Comparison of the incidence of postoperative nausea and vomiting between women undergoing open or robot-assisted thyroid
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and Other Interventional Techniques
Comparison of the incidence of postoperative nausea and vomiting between women undergoing open or robot-assisted thyroidectomy Ji Young Yoo • Yun Jeong Chae • Han Bum Cho Kyu Hyun Park • Jin Su Kim • Sook Young Lee
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Received: 29 May 2012 / Accepted: 14 September 2012 / Published online: 13 December 2012 Ó Springer Science+Business Media New York 2012
Abstract Background Open thyroidectomy is associated with a high incidence of postoperative nausea and vomiting (PONV) in up to 70 % of cases. Use of the recently introduced robot-assisted endoscopic thyroidectomy using a gasless transaxillary approach has been increasing because of its several advantages over open thyroidectomy. This study compared the incidence of PONV in the women who underwent open or robot-assisted thyroidectomy. Methods This prospective, double-blinded study enrolled 170 women 20–60 years of age who were scheduled for conventional open thyroidectomy (group O) or robotassisted thyroidectomy (group R). A standard anesthetic technique, including sevoflurane and air in oxygen, was used. During a 0–24-h postoperative period, the presence and severity of PONV (nausea, retching/vomiting), severity of pain, need for rescue antiemetics, and the degree of patient satisfaction were evaluated. Results During the 0–6-h postoperative period, the incidence of PONV and mean pain score (40.0 vs. 51.8 %and 4.2 vs. 4.8 in groups R and O, respectively) were not significantly different. At 6–24 h postoperatively, the incidence of PONV (18.8 vs. 44.7 %), severe emesis (11.8 vs. 29.4 %) and mean pain score (2.8 vs. 3.8) were significantly lower in group R compared to group O, respectively. Overall, the incidence of PONV (42.4 vs. 63.5 %) and severe emesis (20.0 vs. 43.5 %) were significantly lower in J. Y. Yoo Department of Anesthesia and Pain Medicine, Korea University Ansan Medical Center, Ansan, Korea Y. J. Chae H. B. Cho K. H. Park J. S. Kim S. Y. Lee (&) Department of Anesthesia and Pain Medicine, School of Medicine, Ajou University, Suwon, Korea e-mail: [email protected]
group R compared to group O, respectively. The incidence of satisfied patients 6 and 24 h after the end of anesthesia (55.3 vs. 28.2 and 82.4 vs. 58.8 %) were significantly higher in group R compared to group O, respectively. Conclusions Robotic thyroidectomy reduces the incidence and severity of PONV compared to open thyroidectomy during a 0–24-h postoperative period. Keywords Open thyroidectomy Postoperative nausea and vomiting Robotic thyroidectomy
Postoperative nausea and vomiting (PONV) are the main cause of discomfort after thyroid surgery and anesthesia, and can predispose patients to aspiration of gastric contents, wound dehiscence, delayed discharge, and higher medical costs [1, 2]. Additionally, vomiting may increase the risk of postoperative bleeding, which may potentially cause airway obstruction [2]. These events justify the importance of reducing the likelihood of PONV occurrence. Robot-assisted thyroidectomy using the gasless t
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