General anesthesia with azasetron and dexamethasone in two different methods in prevention of postoperative nausea and vomiting

Abstract

Objective To compare the clinical effects of general anesthesia with azasetron and dexamethasone in two different methods in prevention of postoperative nausea and vomiting (PONV). Methods 120 patients undergoing gynecologic laparoscopic surgery at our hospital from January, 2015 to January, 2018 were selected and randomly divided into a propofol (group P), a propofol + azasetron + dexamethasone (group PAD), a sevoflurane (group S),and a sevoflurane + azasetronl + dexamethasone (group SAD), 30 cases for each group. Group P and group PAD were maintained by target controlled infusion (TCI) of 3-4 μg/ml propofol; 10 mg dexamethasone was given after intubation and 10 mg azasetron was given at the end of operation in group PAD. Group S and SAD were maintained by 2.5%-3.0% sevoflurane; 10 mg dexamethasone was given after intubation and 10 mg azasetron was given at the end of operation in group SAD. The occurrences of nausea and vomiting within 24 hours after surgery were observed and recorded. Results There were no statistical differences in patient characteristics, hemodynamic changes, surgery time, anesthesia time, extubation time, the fentanyl dosage, and Visual analogue scale (VAS) within 24 hours after surgery among the 4 groups (all P>0.05). Compared with other groups, the satisfaction score within 24 hours after surgery in group S was significantly decreased (P<0.05). Compared with group P, the incidence of PONV in group PAD was significantly decreased(6.7% vs. 30.0%) (P=0.042). Compared with group S, the incidence of PONV in group SAD was significantly decreased (13.3% vs. 50.0%)(P=0.005). Compared with those received sevoflurane anesthesia, the relative risk of PONV for those received propofol was 0.6. The relative risks of PONV for those received azasetron combined with dexamethasone and propofol or sevoflurane anesthesia were 0.22 or 0.27. Compared with those received only anesthetics, the relative risk of PONV for those received antiemetics was 0.25. Conclusion Compared with propofol anesthesia, sevoflurane anesthesia is inclined to PONV in patients; azasetronl combined with dexamethasone have good effect in the prevention of postoperative nausea and vomiting under general anesthesia in two different methods, especially under sevoflurane anesthesia. Key words: Azasetron; Dexamethasone; General anesthesia; Gynecologic laparoscopic surgery; Postoperative nausea and vomiting