Abstract
PURPOSE: The aim of this trial was to investigate postoperative nausea and vomiting (PONV) incidence between low- and high-dose remifentanil with propofol for total intravenous anaesthesia (TIVA) in adult female patients with gynecologic laparoscopy. PATIENTS AND METHODS: The randomized clinical trial consisted of two groups: 0.1ug/kg/min remifentanil (L group) (n=39) and 0.4ug/kg/min remifentanil (H group) (n=40). Both of them was titrated with propofol to maintain bispectral index (BIS) values between 40 and 60. Forty-eight-hour PONV and postoperative visual analogue scale (VAS) and haemodynamic parameters and recovery quality and the concentrations of propofol TCI during the intraoperative periods were evaluated. RESULTS: PONV incidences at 2, 6, 24, and 48 hours were 12.5%, 15%, 20% and 20% in (H group) and 25.6%, 25.6%, 25.6%, and 25.6% in (L group), but no statistical difference between groups (all P values > 0.05). H group reduced propofol use and recovery time (6.5 ± 4.8 versus. 8.7 ± 4.4 P = 0.036) but increased norepinephrine requirements (0 (0, 8) vs 0 (0, 0) P = 0.005). PCA use and first analgesic request time were similar. CONCLUSION: High-dose remifentanil regimens for TIVA would not increase the incidence of PONV, however, significantly reduce the demand for propofol, and promote rapid recovery of patients.