Propofol maintenance to reduce postoperative emesis in thyroidectomy patients: A group sequential comparison with isoflurane/nitrous oxide

The clinical benefit of propofol anaesthesia in the prevention of postopera tive nausea and vomiting (PONV) is still being elucidated despite many stud ies to date. In this study 64 adult female patients scheduled for thyroidec tomy received, in a randomized double-blind fashion, propofol with air or i soflurane with nitrous oxide for maintenance of anaesthesia. The primary re sponse variable was the presence or absence of vomiting in the first six ho urs. A group sequential design was used to allow interim analysis. After 64 patients, the fourth analysis showed that fewer patients receiving propofo l vomited or required an anti-emetic during the first six hours (P<0.05). T here was no significant difference detected in the 6 to 24 hour interval. I n this group of female patients, total intravenous anaesthesia (TIVA) with propofol is associated with an early reduction in early postoperative vomit ing compared with standard inhalational techniques. This reduction in vomit ing does not appear to persist beyond the first six hours.