Subhypnotic propofol does not treat postoperative vomiting in children after adenotonsillectomy.

Abstract

PURPOSE:

To investigate the efficacy of a subhypnotic dose of propofol to treat vomiting in children after adenotonsillectomy.

METHODS:

Two hundred and fifty-two children, aged 2-12 yr, underwent a standardized anaesthetic opioid administration, and postoperative care after adenotonsillectomy, adenoidectomy or tonsillectomy. A prospective, double-blinded, placebo-controlled study was performed in 70 of the patients who retched or vomited after surgery and who had intravenous access. Patients were assigned randomly to receive either 0.2 mg.kg-1) propofol (n = 35), or placebo (intralipid 10%, n = 35).

RESULTS:

The overall incidence of vomiting during the first 18-24 hr was 50%. Of those who had received propofol after the first episode of vomiting, 63% relapsed requiring a rescue antiemetic compared with 57% of those who had received intralipid (P = NS). Of the children who received propofol, 54% experienced pain on injection and 46% were mildly sedated compared with 3% and 11%, respectively, in the placebo group (P < 0.003).

CONCLUSION:

We conclude that an intravenous bolus of 0.2 mg.kg-1 propofolis not effective in the treatment of postoperative vomiting in children after adenotonsillectomy when a standardized anaesthetic with thiopentone, halothane, nitrous oxide, and 1.5 mg.kg-1 codeine phosphate is used, but it does cause sedation and pain on injection.

• Authors: M M Zestos, A S Carr, G McAuliffe, H S Smith, N Sikich, J Lerman
• Journal: Canadian journal of anaesthesia = Journal canadien d'anesthesie (Can J Anaesth) Vol. 44 Issue 4 Pg. 401-4 (Apr 1997) ISSN: 0832-610X [Print] United States
• PMID: 9104523 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics, Opioid
• Anesthetics, Inhalation
• Anesthetics, Intravenous
• Antiemetics
• Fat Emulsions, Intravenous
• Hypnotics and Sedatives
• Placebos
• Thiopental
• Nitrous Oxide
• Halothane
• Codeine
• Propofol

Topics

• Adenoidectomy (adverse effects)
• Analgesics, Opioid (administration & dosage)
• Anesthetics, Inhalation (administration & dosage)
• Anesthetics, Intravenous (administration & dosage)
• Antiemetics (administration & dosage, adverse effects, therapeutic use)
• Child
• Child, Preschool
• Codeine (administration & dosage)
• Double-Blind Method
• Fat Emulsions, Intravenous (administration & dosage, therapeutic use)
• Halothane (administration & dosage)
• Humans
• Hypnotics and Sedatives (administration & dosage, adverse effects, therapeutic use)
• Incidence
• Injections, Intravenous (adverse effects)
• Nitrous Oxide (administration & dosage)
• Pain (etiology)
• Placebos
• Postoperative Complications (drug therapy)
• Propofol (administration & dosage, adverse effects, therapeutic use)
• Prospective Studies
• Recurrence
• Thiopental (administration & dosage)
• Tonsillectomy (adverse effects)
• Vomiting (drug therapy)