Discussion
PONV, hypotension, hypercarbia, Postoperative pain
MOTION SICKNESS, NEUROMUSCULAR BLOCKADE
Although remimazolam is a novel drug, several studies have reported its use as an anesthetic. Its sedative effect can be rapidly reversed by flumazenil. Therefore, it is used successfully in clinical practice [Previous studies have reported that remimazolam does not increase PONV compared with propofol. Choi et al. [Prakash et al. [Postoperative pain is considered a risk factor for PONV [There were no differences between groups in the QoR-40 used to compare the quality of recovery. Considering that PONV has a significant impact on recovery, the similar incidence of PONV between the two groups may have contributed to this outcome [Despite various efforts to reduce PONV, the incidence of PONV is still 20–30%, and can be as high as 80% in high-risk groups [The Apfel simplified risk score is a tool commonly used for PONV risk assessment, and it has been used to identify female sex, nonsmoking status, history of PONV or motion sickness, and postoperative opioid use as risk factors for PONV occurrence [Antiemetics that are used for the relief of PONV act by blocking the dopamine (DFurthermore, sugammadex was administered as a reverse non-depolarizing muscle relaxant, which may have reduced the incidence of PONV. Cholinesterase inhibitors are used to reverse non-depolarizing neuromuscular blockade, which may be associated with increased incidence of PONV. Several reports have stated that the reversal of neuromuscular blocking action using sugammadex induces less PONV than the use of cholinesterase inhibitors such as neostigmine [This study has several limitations. First, we calculated the sample size based on an unpublished preliminary study. Second, since the analysis did not involve categorization according to the type of surgery, the postoperative oral conditions were not consistent among the patients. Third, PONV beyond 24 h after surgery was not examined. Therefore, further studies with a sufficient number of participants undergoing the same type of surgery are needed to investigate the incidence of PONV beyond this point. In addition, we did not compare the two groups for many factors that affect the occurrence of PONV, such as hypotension and hypercarbia [