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Anesth Analg 2006;103:1260-1263
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000240872.08802.f0

GENERAL ARTICLES

The Twenty-Degree Reverse-Trendelenburg Position Decreases the Incidence and Severity of Postoperative Nausea and Vomiting After Thyroid Surgery

Kiyo Tominaga, MD, and Toshiyuki Nakahara, MD

From the Department of Anesthesiology, Tokushima Municipal Hospital, Tokushima, Japan.

Address correspondence and reprint requests to Kiyo Tominaga, 2-34 Kitajosanjima-Cho, Tokushima 770-0812, Japan. Address e-mail to kiyokorin{at}yahoo.co.jp.

BACKGROUND: In this randomized, single-blind, controlled study, we evaluated whether the 20° reverse-Trendelenburg position had an effect on postoperative nausea and vomiting in patients undergoing thyroid surgery.

METHODS: Patients (n = 224) were given a standardized propofol anesthetic. Intraoperatively, patients were randomly assigned into two groups according to the tilt of the table maintained during surgery: patients were positioned with the neck extended and the table tilted with 20° reverse-Trendelenburg or with the neck extended and the table positioned at a horizontal tilt. All episodes of postoperative nausea, vomiting, nausea severity score, frequency of vomiting, and the use of antiemetics were recorded during the first 24 h after anesthesia. We divided this time period into 0–3 h and 3–24 h.

RESULTS: During the 0–3 h postoperative period, all observed episodes were comparable between groups. However, during the 3–24 h and the overall postoperative period, the incidence of nausea and/or vomiting, the nausea severity score, and frequency of vomiting were significantly less in the 20° reverse-Trendelenburg position.

CONCLUSION: The 20° reverse-Trendelenburg position effectively ameliorates postoperative nausea and/or vomiting.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.