Prevention of postoperative nausea and vomiting with antiemetics in patients undergoing middle ear surgery: comparison of a small dose of propofol with droperidol or metoclopramide.

Abstract

OBJECTIVE:

To compare the efficacy and safety of a small dose of propofol with other commonly used antiemetics, droperidol and metoclopramide, for the prevention of postoperative nausea and vomiting in patients undergoing middle ear surgery.

DESIGN:

Prospective, randomized, double-blind study.

SETTING:

University-affiliated teaching hospital.

PATIENTS:

Ninety patients (48 females, 42 males) scheduled for middle ear surgery.

INTERVENTION:

Patients received propofol, 0.5 mg/kg, droperidol, 20 microg/kg, or metoclopramide hydrochloride, 0.2 mg/kg, intravenously at the end of the surgical procedure. A standardized general anesthetic technique was employed throughout the surgical procedure.

MAIN OUTCOME MEASURE:

Emetic episodes and safety assessment were performed during 2 periods-0 to 3 hours in the postanesthetic care unit and 3 to 24 hours in the ward-after receiving anesthesia.

RESULTS:

The incidence of patients who were emesis free during the 0- to 3-hour period after receiving anesthesia was 93% for those who received propofol, 73% for those who received droperidol, and 70% for those who received metoclopramide, respectively; the respective corresponding incidence during the 3- to 24-hour period after receiving anesthesia was 90%, 67%, and 60% (P<.05, overall Fisher exact probability test). No clinically adverse events were observed in any of the groups.

CONCLUSION:

A small dose of propofol is a better antiemetic than droperidol or metoclopramide for the prevention of postoperative nausea and vomiting after middle ear surgery.

• Authors: Y Fujii, H Tanaka, N Kobayashi
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 127 Issue 1 Pg. 25-8 (Jan 2001) ISSN: 0886-4470 [Print] United States
• PMID: 11177010 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Retracted Publication)

Chemical References

• Antiemetics
• Metoclopramide
• Droperidol
• Propofol

Topics

• Adult
• Analysis of Variance
• Antiemetics (administration & dosage, therapeutic use)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Droperidol (administration & dosage, therapeutic use)
• Ear, Middle (surgery)
• Female
• Humans
• Male
• Metoclopramide (administration & dosage, therapeutic use)
• Middle Aged
• Postoperative Nausea and Vomiting (prevention & control)
• Propofol (administration & dosage, therapeutic use)