This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .
Randomized controlled trial of total intravenous anesthesia with propofol versus inhalation anesthesia with isoflurane-nitrous oxide: postoperative nausea with vomiting and economic analysis.
BACKGROUND To assess the incidence of postoperative nausea and vomiting after  total intravenous anesthesia ( TIVA ) with propofol versus inhalational anesthesia with isoflurane-nitrous oxide , the authors performed a r and omized trial in 2,010 unselected surgical patients in a Dutch academic institution . An economic evaluation was also performed . METHODS Elective in patients ( 1,447 ) and out patients ( 563 ) were r and omly assigned to inhalational anesthesia with isoflurane-nitrous oxide or TIVA with propofol-air . Cumulative incidence of postoperative nausea and vomiting was recorded for 72 h by blinded observers . Cost data of anesthetics , antiemetics , disposables , and equipment were collected . Cost differences caused by duration of postanesthesia care unit stay and hospitalization were analyzed . RESULTS Total intravenous anesthesia reduced the absolute risk of postoperative nausea and vomiting up to 72 h by 15 % among in patients ( from 61 % to 46 % , P < 0.001 ) and by 18 % among out patients ( from 46 % to 28 % , P < 0.001 ) . This effect was most pronounced in the early postoperative period . The cost of anesthesia was more than three times greater for propofol TIVA .  Median duration of stay in the postanesthesia care unit was 135 min after isoflurane versus 115 min after TIVA for in patients ( P < 0.001 ) and 160 min after isoflurane versus 150 min after TIVA for out patients ( P = 0.039 ) . Duration of hospitalization was equal in both arms . CONCLUSION Propofol TIVA results in a clinical ly relevant reduction of postoperative nausea and vomiting compared with isoflurane-nitrous oxide anesthesia ( number needed to treat = 6 ) . Both anesthetic techniques were otherwise similar . Anesthesia costs were more than three times greater for propofol TIVA , without economic gains from shorter stay in the postanesthesia care
This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .