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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.23939    [Epub ahead of print]
Published online April 19, 2024.
The incidences of nausea and vomiting after general anesthesia with remimazolam versus sevoflurane: a prospective randomized controlled trial
Yeong Min Yoo1,2  , Jae Hong Park3  , Ki Hwa Lee3  , Ah Hyeon Yi1  , Tae Kyun Kim1,2 
1Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
2Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea
3Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
Corresponding author:  Tae Kyun Kim, Tel: +82-55-360-2756, Fax: +82-55-360-2756, 
Email: anesktk@pusan.ac.kr
Received: 19 December 2023   • Revised: 19 March 2024   • Accepted: 26 March 2024
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.
Key Words: Analgesics; Antiemetics; Benzodiazepines; Nausea; Sevoflurane; Vomiting


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