4. Discussion
PONV, postoperative pain, PONV.Factors, tympanoplasty
MIDDLE EAR
This study aimed to compare the incidence rate of PONV 0–12 h after tympanoplasty with mastoidectomy under general anesthesia between using intravenous remimazolam and volatile sevoflurane. Based on the study data, the incidence rate of PONV 12 h after the middle ear surgery was significantly lower in the remimazolam group compared with the sevoflurane group. Furthermore, PONV severity 0–12 h after the surgery was statistically lower in the remimazolam group than in the sevoflurane group. However, no statistically significant differences were found in the incidence rates and severity of PONV 12–24 and 24–48 h after surgery. Hence, the outcome of this study suggests that the administration of remimazolam rather than sevoflurane as an anesthetic reduces relatively early PONV, but not delayed PONV.Factors that cause PONV are multifactorial [The incidence of PONV is associated with postoperative pain and perioperative use of opioids [There are some studies that demonstrate the efficacy and safety of remimazolam in terms of hemodynamic stability [Although the incidence rate of early PONV was lower in the remimazolam group compared to the sevoflurane group, the incidence rate of 28.9% could be considered too high to justify the routine use of remimazolam to reduce the incidence of PONV. In future studies, it is considered necessary to compare the incidence of PONV between remimazolam and other anesthetics, including intravenous anesthetics. To the best of our knowledge, few studies have compared the incidence of PONV between remimazolam and other intravenous anesthetics. According to Kim et al. [Our study has some limitations. First, the sample size of this study was relatively small. Thus, further studies with larger sample sizes are required to better confirm the effects of remimazolam in decreasing the incidence rate of early PONV after surgery. Second, we were not able to confirm whether the depth of anesthesia in the remimazolam group was appropriate during the surgery. The BIS is a safe and effective method for monitoring anesthetic depth [