Propofol Decreases Early Postoperative Nausea and Vomiting in Patients Undergoing Thyroid and Parathyroid Operations

BACKGROUND: As the practice of parathyroid and thyroid surgery shifts toward short stay and outpatient treatment, the occurrence and management of postoperative nausea and vomiting (PONV) increases in importance due to its potential to delay discharge. PONV also may contribute negatively to the patient's experience and thus their level of satisfaction. The purpose of this study was to determine whether anesthetic technique based on propofol decreases the incidence of PONV and, consequently, improves patient satisfaction with their care. METHODS: A prospective, randomized trial included patients undergoing thyroidectomy and parathyroidectomy under general anesthetic with (75 patients) or without (73 patients) propofol. Occurrences of nausea, vomiting, and the resultant treatment were tracked during the perioperative period. Repeated questionnaires at multiple time points determined patient expectations and experiences related to PONV after their operation. Statistical analyses compared differences between the propofol and non-propofol groups. RESULTS: PONV was significantly less likely in the propofol group at the early time points (in the operating room and postanesthesia care unit) but not at later time points (postoperative day 1 or 2). Patients were largely satisfied with different aspects of their management despite the specifics of their anesthetic regimen. CONCLUSIONS: A propofol-based anesthetic decreases PONV immediately after the operation but this influence does not persist throughout the episode of care or significantly contribute to patient perceptions of satisfaction.