Comparison the effects of fentanyl, sufentanil and alfentanil as premedication on post-operative nausea and vomiting in diagnostic gynecologic laparascopy

Reduction of post-operative nausea and vomiting (PONV)) promotes discharge of patients and reduces healthcare costs, hospital re–admission and duration of stay of patients in hospital, and finally satisfies patients. In this study, the effects of three opioids that are used routinely in general anesthesia (alfentanil, sufentanil and fentanyl) were assessed on the incidence of PONV. In this double-blind clinical trial, one hundred eighty patients (ASA I and II), aged 18-35 year, were randomly allocated into three groups. All three groups were firstly received 1mg midazolam 2minutes before anesthesia and then each group received 2cc of one of following opioid drugs: Alfentanil, fentanyl and sufentail (the general anesthesia method was similar in three groups). PONV was assessed 2hrs and 2-24hrs in post-operative period in these three groups. Incidence of postoperative nausea was respectively 13.33 %, 35% and 41.6% in alfentanil, fentanyl and sufentailgroup in the first 24hrs of post-operative period. Incidence of nausea was significantly lower in alfentanil group in the first 2hrs (p<0.001) and 0-24hrs (p<0.01) in post-operative period. No significant difference was observed in the incidence of vomiting between three groups in 24hrs of post-operative period. Overall, in the first 24hrs post-operative period, there was no difference between the effects of alfentanil, fentanyl and sufentanil on postoperative vomiting, while alfentanil can be consider with lower effects in nausea incidence for post-operative periods