{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T22:48:05Z","timestamp":1772059685169,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Postoperative nausea and vomiting (PONV) is a common and disturbing problem in patients undergoing ambulatory thyroidectomy. This prospective trial aimed to explore whether dexmedetomidine (DEX) combined with azasetron (AZA) can further drop the incidence of PONV in patients undergoing ambulatory thyroidectomy compared with AZA.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This single-center, randomized, double-blind trial involved 172 adult patients undergoing ambulatory thyroidectomy. The individuals were randomized to DEX + AZA group and AZA group. In the DEX + AZA group, patients received dexmedetomidine 0.5 \u03bcg kg<jats:sup>\u22121<\/jats:sup> for 10 min and then the infusion rate was held at 0.1 \u03bcg kg<jats:sup>\u22121<\/jats:sup> h<jats:sup>\u22121<\/jats:sup> until the completion of the operation, while the same amount of 0.9% saline in the AZA group. At the completion of the surgery, 10 mg azasetron was administered to every patient in both groups. The primary outcome was the incidence of 24 h PONV after ambulatory thyroidectomy. The secondary outcomes included residence time in recovery room, pain scores, severity of nausea, and adverse events.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> No significant difference was found in the incidence of 24-h PONV between the DEX + AZA group and the AZA group [36% (30 of 84) vs. 38% (32 of 84); relative risk, 0.94; 95% confidence interval (CI), 0.63\u20131.40; <jats:italic>P<\/jats:italic> = 0.749]. The incidence of severe nausea was similar between the DEX + AZA group and the AZA group [57% (12 of 21) vs. 43% (9 of 21); relative risk, 1.33; 95% CI, 0.72\u20132.50; <jats:italic>P<\/jats:italic> = 0.355].<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Intraoperative dexmedetomidine combined with azasetron failed to drop the incidence of 24-h PONV compared with azasetron alone in patients undergoing ambulatory thyroidectomy.<\/jats:p>","DOI":"10.3389\/fmed.2021.781689","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T06:31:27Z","timestamp":1639377087000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Effects of Dexmedetomidine on Postoperative Nausea and Vomiting in Adult Patients Undergoing Ambulatory Thyroidectomy: A Randomized Clinical Trial"],"prefix":"10.3389","volume":"8","author":[{"given":"Cuiyu","family":"Xie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caihui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s12020-020-02207-6","article-title":"Thyroid cancer: incidence and mortality trends in China, 2005\u20132015","volume":"68","author":"Wang","year":"2020","journal-title":"Endocrine."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1702","DOI":"10.3389\/fonc.2020.01702","article-title":"Epidemiology of thyroid cancer: incidence and mortality in China, 2015","volume":"10","author":"Du","year":"2020","journal-title":"Front Oncol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.surg.2019.06.054","article-title":"Same-day discharge is not associated with increased readmissions or complications after thyroid operations","volume":"167","author":"Hu","year":"2020","journal-title":"Surgery."},{"key":"B4","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1007\/s40618-019-01043-4","article-title":"Financial benefit in outpatient thyroid surgery","volume":"42","author":"Cozzaglio","year":"2019","journal-title":"J Endocrinol Invest."},{"key":"B5","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1097\/00000542-199207000-00023","article-title":"Postoperative nausea and vomiting. Its etiology, treatment, and prevention","volume":"77","author":"Watcha","year":"1992","journal-title":"Anesthesiology."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2441","DOI":"10.1056\/NEJMoa032196","article-title":"A factorial trial of six interventions for the prevention of postoperative nausea and vomiting","volume":"350","author":"Apfel","year":"2004","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e14542","DOI":"10.1097\/MD.0000000000014542","article-title":"Pharmacologic interventions for postoperative nausea and vomiting after thyroidectomy","volume":"98","author":"Cho","year":"2019","journal-title":"Medicine."},{"key":"B8","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1097\/SLA.0000000000001112","article-title":"Efficacy of a single preoperative dexamethasone dose to prevent nausea and vomiting after thyroidectomy (the tPONV Study)","volume":"262","author":"Tarantino","year":"2015","journal-title":"Ann Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1213\/ANE.0000000000004833","article-title":"Fourth consensus guidelines for the management of postoperative nausea and vomiting","volume":"131","author":"Gan","year":"2020","journal-title":"Anesth Anal."},{"key":"B10","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1111\/anae.14657","article-title":"Intra-operative analgesia with remifentanil vs. dexmedetomidine: a systematic review and meta-analysis with trial sequential analysis","volume":"74","author":"Grape","year":"2019","journal-title":"Anaesthesia."},{"key":"B11","doi-asserted-by":"publisher","first-page":"5060","DOI":"10.1177\/0300060519872031","article-title":"Antiemetic efficacy of dexmedetomidine versus dexmedetomidine-dexamethasone combination in patients undergoing breast surgery","volume":"47","author":"Kwak","year":"2019","journal-title":"J Int Med Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1097\/ALN.0000000000003286","article-title":"Olanzapine for the prevention of postdischarge nausea and vomiting after ambulatory surgery","volume":"132","author":"Hyman","year":"2020","journal-title":"Anesthesiology."},{"key":"B13","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1097\/EJA.0000000000000491","article-title":"Intra-operative dexmedetomidine reduces early postoperative nausea but not vomiting in adult patients after gynaecological laparoscopic surgery","volume":"33","author":"Geng","year":"2016","journal-title":"Eur J Anaesth."},{"key":"B14","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.ejphar.2013.10.037","article-title":"Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting","volume":"722","author":"Horn","year":"2014","journal-title":"Eur J Pharmacol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"813","DOI":"10.2165\/00023210-200721100-00003","article-title":"Mechanisms underlying postoperative nausea and vomiting and neurotransmitter receptor antagonist-based pharmacotherapy","volume":"21","author":"Gan","year":"2007","journal-title":"Cns Drugs."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1884","DOI":"10.1213\/01.ANE.0000219597.16143.4D","article-title":"Risk factors for postoperative nausea and vomiting","volume":"102","author":"Gan","year":"2006","journal-title":"Anesth Anal."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.21037\/gs-20-225","article-title":"Propofol-based total intravenous anesthesia decreases the incidence of postoperative nausea and vomiting without affecting flap survival in free flap breast reconstruction","volume":"9","author":"Yang","year":"2020","journal-title":"Gland Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1093\/bja\/aes276","article-title":"Evidence-based analysis of risk factors for postoperative nausea and vomiting \u2020","volume":"109","author":"Apfel","year":"2012","journal-title":"Br J Anaesth."},{"key":"B19","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1097\/EJA.0000000000000327","article-title":"Dexmedetomidine added to an opioid-based analgesic regimen for the prevention of postoperative nausea and vomiting in highly susceptible patients","volume":"33","author":"Song","year":"2016","journal-title":"Eur J Anaesth."},{"key":"B20","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1093\/bja\/aeq091","article-title":"Incidence of postoperative nausea and vomiting after paediatric strabismus surgery with sevoflurane or remifentanil\u2013sevoflurane","volume":"104","author":"Oh","year":"2010","journal-title":"Br J Anaesth."},{"key":"B21","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/S0952-8180(02)00353-7","article-title":"Postoperative nausea and vomiting after total intravenous anesthesia with propofol and remifentanil or alfentanil: how important is the opioid?","volume":"14","author":"Dershwitz","year":"2002","journal-title":"J Clin Anesth."},{"key":"B22","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1007\/s00540-019-02715-4","article-title":"The association of intraoperative end-tidal carbon dioxide with the risk of postoperative nausea and vomiting","volume":"34","author":"Fujimoto","year":"2020","journal-title":"J Anesth."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1213\/ANE.0000000000002763","article-title":"Dexmedetomidine for improved quality of emergence from general anesthesia","volume":"129","author":"Aoud","year":"2019","journal-title":"Anesth Anal."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.781689\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T06:31:33Z","timestamp":1639377093000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.781689\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,13]]},"references-count":23,"alternative-id":["10.3389\/fmed.2021.781689"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2021.781689","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,13]]},"article-number":"781689"}}