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Effect of Glycopyrrolate as a Premedication on Postoperative Nausea, Vomiting, And Pain in Patients Receiving Opioid-Based Intravenous Patient-Controlled Analgesia after Thyroidectomy: A Propensity Score Matching Analysis

Background: This retrospective study evaluated the effects of glycopyrrolate as a premedication on postoperative nausea and vomiting (PONV) and pain. Materials and Methods: We reviewed the electronic medical records of 992 adults who received intravenous fentanyl-based intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy at the Chung-Ang University Hospital between January 1, 2010 and December 31, 2015. We classified the patients into two groups, namely no glycopyrrolate group (Group N, n = 726) and glycopyrrolate group (Group A, n = 266). We then selected 362 patients in a 1: 1 ratio by the propensity score matching (PSM) method. Continuous variables were analyzed by Student’s t-test or Mann–Whitney U test before PSM, and by paired t-test or Wilcoxon signed rank test after PSM. Descriptive variables were analyzed using the χ2 or Fisher’s exact tests before PSM, and using the Mc Nemar’s test after PSM. Results: Prior to PSM, the severity of nausea measured using numeric rating scale scores, and the use of rescue antiemetic on postoperative day (POD) 0 was lower in Group A than that in Group N (p = 0.035 and p < 0.001, respectively). In addition, the frequency of vomiting and dizziness on POD 0 was lower in Group A than that in Group N (p = 0.029 and p = 0.018, respectively). After PSM, these differences were no longer statistically significant, except for the use of rescue anti emetics on POD 0 (p = 0.034). Conclusions: Glycopyrrolate has no effect on the severity of nausea and frequency of vomiting in patients receiving opioid-based IV-PCA after thyroidectomy. However, fewer patients in the glycopyrrolate group used rescue anti emetics on POD 0.