AUTHOR=Cho Ho Bum , Park Sun Young , Kim Nayoung , Choi Sang Jin , Song Sanghoon , Yoo Jae Hwa , Kim Mun Gyu , Chung Ji Won TITLE=Effect of anesthetics on postoperative nausea and vomiting after peripheral vascular surgery in end-stage renal disease patients: A retrospective observational study JOURNAL=Frontiers in Surgery VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.1054670 DOI=10.3389/fsurg.2022.1054670 ISSN=2296-875X ABSTRACT=Background

Propofol-based total intravenous anesthesia (TIVA) is considered a prophylactic approach to decrease postoperative nausea and vomiting (PONV). Despite general anesthesia commonly being performed in end-stage renal disease (ESRD) patients, PONV in ESRD patients has not been well-described. We investigated PONV in peripheral vascular surgery under general anesthesia in ESRD patients.

Methods

To compare PONV between propofol-based TIVA and anesthesia with volatile anesthetics, we collected retrospective data from patients who underwent peripheral vascular surgery under general anesthesia from July 2018 to April 2020. We performed univariable and multivariable analyses, including factors that could be associated with PONV and those previously shown to affect PONV.

Result

A total of 1,699 peripheral vascular surgeries under general anesthesia in ESRD patients were eligible for analysis. Based on the multivariable analysis, TIVA (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.35–0.60; P < 0.001) significantly decreased PONV. Female sex (OR, 1.85; 95% CI, 1.44–2.38; P < 0.001) and anesthetic duration (OR, 1.01; 95% CI, 1.00–1.01; P < 0.001) were associated with increased PONV.

Conclusion

Propofol-based TIVA is the most influential factor decreasing PONV after peripheral vascular surgery in ESRD patients. Anesthesiologists can apply propofol-based TIVA as an alternative to anesthesia with volatile anesthetics.