The Effects of Desflurane Versus Conventional Maintenance Anesthetics on the Incidence of Post-Operative Nausea and Vomiting in Patients Undergoing Laparoscopic Surgery

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  • ANDO Koichi
    Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Showa University School of Medicine Showa university Dental hospital Medical Clinic
  • ANDO Akane
    The Division of Anesthesiology, Department of Perioperative Medicine, Showa University School of Dentistry Department of Anesthesiology, Showa University Northern Yokohama Hospital
  • AKIZUKI Ayako
    Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry
  • KAMATANI Takaaki
    Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry
  • GOTO Kinuko
    The Division of Anesthesiology, Department of Perioperative Medicine, Showa University School of Dentistry
  • SHIROTA Tatsuo
    Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry
  • IIJIMA Takehiko
    The Division of Anesthesiology, Department of Perioperative Medicine, Showa University School of Dentistry
  • INOUE Shin
    Showa university Dental hospital Medical Clinic

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  • ―A Network Meta-Analysis of 4 Randomized Controlled Trials―

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It is not fully known if there are significant differences in the incidence of post-operative nausea and vomiting（PONV）in patients undergoing laparoscopic surgery under general anesthesia following administration of desflurane compared to other conventional maintenance anesthetics, such as sevoflurane and propofol. This study was aimed to address this issue using network meta-analysis of relevant randomized controlled trials. Summary effect sizes were calculated as odds ratios（ORs）with 95％ confidence intervals（CIs）. The incidence of PONV after administration of different anesthetics was compared by surface under the cumulative ranking curve（SUCRA）analysis. The odds of desflurane vs sevoflurane, desflurane vs propofol, and sevoflurane vs propofol contributing to the incidence of PONV were 0.44（95％ CI, 0.12-1.61）, 2.43（95％ CI, 0.72-8.26）, and 5.50（95％ CI, 1.78-16.93）, respectively. The SUCRA scores for desflurane, sevoflurane, and propofol were 48.3, 5.6, and 96.1, respectively. The incidence of PONV after desflurane administration did not differ significantly from that after sevoflurane and propofol administration. However, the odds of PONV occurring after sevoflurane administration were significantly higher than those after propofol administration. Moreover, the SUCRA score after desflurane administration was greater than that after sevoflurane administration. These results confirm the safety of desflurane regarding PONV in patients undergoing laparoscopic surgery under general anesthesia.

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