{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:40:38Z","timestamp":1792204838362,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative nausea and vomiting occur frequently following thyroid and parathyroid surgery and are associated with worse patient outcomes. We hypothesised that opioid\u2010free propofol anaesthesia would reduce the incidence of postoperative nausea and vomiting compared with opioid\u2010inclusive propofol anaesthesia in patients undergoing these procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a randomised, double\u2010blinded controlled trial in adult patients scheduled to undergo thyroid and parathyroid surgery at two medical centres in mainland China. Patients were allocated randomly (1:1, stratified by sex and trial site) to an opioid\u2010free anaesthesia group (esketamine, lidocaine, dexmedetomidine and propofol) or an opioid\u2010inclusive group (sufentanil and propofol). Propofol infusions were titrated to bispectral index 45\u201355. Patients received prophylaxis for nausea and vomiting using dexamethasone and ondansetron and multimodal analgesia with paracetamol and flurbiprofen axetil. The primary outcome was the incidence of postoperative nausea and vomiting in the first 48\u2009h after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We assessed 557 patients for eligibility and 394 completed this trial. The incidence of postoperative nausea and vomiting in the first postoperative 48\u2009h was lower in the opioid\u2010free anaesthesia group (10\/197, 5%) compared with opioid\u2010inclusive group (47\/197, 24%) (OR (95%CI) 0.17 (0.08\u20130.35), p\u2009&lt;\u20090.001), yielding a number needed to treat of 5.3. Additionally, opioid\u2010free propofol anaesthesia was associated with a reduced need for rescue anti\u2010emetics, lower rates of hypotension and desaturation after tracheal extubation, and higher patient satisfaction. Time to tracheal extubation was prolonged slightly in the opioid\u2010free group. The two groups had similar postoperative pain scores and 30\u2010day outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Opioid\u2010free propofol anaesthesia reduced postoperative nausea and vomiting in patients undergoing thyroid and parathyroid surgery. An opioid\u2010free anaesthetic regimen can optimise anaesthetic care during thyroid and parathyroid surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16382","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T09:28:16Z","timestamp":1721640496000},"page":"1072-1080","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Comparison of opioid\u2010free and opioid\u2010inclusive propofol anaesthesia for thyroid and parathyroid surgery: a\u00a0randomised controlled trial"],"prefix":"10.1111","volume":"79","author":[{"given":"Dan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"},{"name":"Institute of Anaesthesiology, Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"},{"name":"Institute of Anaesthesiology, Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010Juan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"},{"name":"Institute of Anaesthesiology, Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi\u2010Sheng","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"},{"name":"Institute of Anaesthesiology, Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine University of California Davis Health  Sacramento CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu\u2010Hai","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"},{"name":"Institute of Anaesthesiology, Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2879-1759","authenticated-orcid":false,"given":"Ke","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"},{"name":"Institute of Anaesthesiology, Soochow University  Suzhou Jiangsu 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