The incidences of nausea and vomiting after general anesthesia with remimazolam versus sevoflurane: a prospective randomized controlled trial.

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  • Additional Information
    • Source:
      Publisher: Korean Society of Anesthesiologists Country of Publication: Korea (South) NLM ID: 101502451 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2005-7563 (Electronic) Linking ISSN: 20056419 NLM ISO Abbreviation: Korean J Anesthesiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Seoul : Korean Society of Anesthesiologists
    • Subject Terms:
      Postoperative Nausea and Vomiting*/prevention & control ; Postoperative Nausea and Vomiting*/epidemiology ; Sevoflurane*/administration & dosage ; Sevoflurane*/adverse effects ; Anesthesia, General*/adverse effects ; Anesthesia, General*/methods ; Anesthetics, Inhalation*/adverse effects ; Anesthetics, Inhalation*/administration & dosage; Humans ; Middle Aged ; Male ; Female ; Prospective Studies ; Aged ; Adult ; Incidence ; Benzodiazepines/adverse effects ; Benzodiazepines/administration & dosage ; Aged, 80 and over ; Antiemetics/administration & dosage ; Antiemetics/adverse effects ; Young Adult ; Hypnotics and Sedatives/administration & dosage ; Hypnotics and Sedatives/adverse effects
    • Abstract:
      Background: Postoperative nausea and vomiting (PONV) refers to nausea and vomiting that occurs within 24-h after surgery or in the post-anesthesia care unit (PACU). Previous studies have reported that the use of remimazolam, a newer benzodiazepine (BDZ) hypnotic, for anesthesia results in less PONV. In this study, we compared the rate of PONV between sevoflurane and remimazolam after general anesthesia.
      Methods: In this prospective randomized controlled trial, participants aged 20-80 years who underwent elective laparoscopic cholecystectomy or hemicolectomy were randomized to either the remimazolam or sevoflurane group. The primary outcome was PONV incidence for 24-h after surgery. Secondary outcomes comprised of PONV at 30-min post-surgery, postoperative additional antiemetic use, and Quality of Recovery-15 (QOR-15) score at 24-h postoperatively.
      Results: Forty patients were enrolled in the study. The remimazolam group exhibited significantly lower rates of PONV for 24-h after surgery than did the sevoflurane group (remimazolam group vs. sevoflurane group; 5% vs. 45%, P = 0.003, respectively). The use of dexamethasone, a rescue antiemetic administered within 24 h of surgery, was substantially lower in the remimazolam group than in the sevoflurane group (0% in remimazolam vs. 30% in sevoflurane, P = 0.020). The QOR-15 score at 24-h after surgery showed no significant difference between the two groups.
      Conclusions: Compared to sevoflurane, opting for remimazolam as an intraoperative hypnotic may decrease the incidence of PONV and reduce antiemetic use for 24 h after laparoscopic surgery.
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    • Grant Information:
      202315650001-2 Pusan National University
    • Contributed Indexing:
      Keywords: Analgesics; Antiemetics; Benzodiazepines; Nausea; Sevoflurane; Vomiting
    • Accession Number:
      38LVP0K73A (Sevoflurane)
      7V4A8U16MB (remimazolam)
      0 (Anesthetics, Inhalation)
      12794-10-4 (Benzodiazepines)
      0 (Antiemetics)
      0 (Hypnotics and Sedatives)
    • Publication Date:
      Date Created: 20240418 Date Completed: 20240731 Latest Revision: 20240804
    • Publication Date:
      20240804
    • Accession Number:
      PMC11294881
    • Accession Number:
      10.4097/kja.23939
    • Accession Number:
      38637272