Prevention of postoperative nausea and vomiting after gynaecological day surgery under remimazolam general anesthesia：A randomized double-blind controlled study

Purpose: To observe the effect of different antiemetic drugs for the prevention of postoperative nausea and vomiting(PONV)after gynaecological day surgery under remimazolam general anesthesia. Methods: : 192 patients were selected for gynaecological day surgery and randomly divided into three groups: droperidol group (DD group) , tropisetron group (DT group) and control group (DC group).Flurbiprofen axetil 50mg and dexamethasone 5mg were given intravenously before induction of anesthesia, and 2 minutes later droperidol 1mg was given intravenously to the DD group, tropisetron 5mg to the DT group and saline (5ml) to the DC group. Induction of anesthesia: remimazolam 6mg/kg/h was continuously pumped to sleep, mivacurium 0.2mg/kg and alfentanil 20ug/kg were slowly pushed, 3 minutes later intubation was performed to control breathing. Maintenance of anesthesia: 40ug/kg/h of alfentanil, 1mg/kg/h of remimazolam continuous infusion. After awakening and extubation, the patient was transferred to the PACU. PONV were recorded in the PACU and an electronic questionnaire was pushed 24 h after surgery. Results: The incidence of PONV within the PACU was significantly lower in the DD (14.5%)and DT(26.7%) groups than in the DC(50%) group ( p <0.01),there was no significantly difference between the DT and DD groups. There were no significant difference in the incidence of PONV in 24 h after surgery between the three groups(DD:DT:DC=44.5%:45.1%:63.8%, p >0.05). Conclusions: Droperidol or tropisetron combined with dexamethasone is superior to dexamethasone alone for the prevention of PONV in the PACU after remimazolam combined with alfentanil anesthesia, with no significant difference in the incidence of PONV in 24 h after surgery.