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Comparison of subhypnotic doses of thiopentone vs propofol on the incidence of postoperative nausea and vomiting following middle ear surgery
Author(s) -
Honkavaara P.,
Saarnivaara L.
Publication year - 1998
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1998.tb05111.x
Subject(s) - retching , medicine , propofol , anesthesia , droperidol , antiemetic , vomiting , acepromazine , nausea , fentanyl , postoperative nausea and vomiting , tonsillectomy , incidence (geometry) , surgery , blood pressure , heart rate , physics , optics
Background : Middle ear surgery is associated with a high incidence of emetic sequelae and propofol has been reported to have antiemetic activity in subhypnotic doses. Methods : In a double‐blind, randomized study, the patients received either thiopentone 1.0 mg.kg ‐1 (n=26) or 0.5 mg.kg ‐1 propofol (n=26) at the end of middle ear surgery under isoflurane‐N 2 O‐fentanyl‐vecuronium anaesthesia. Trained nurses, unaware of the group assignment, assessed postoperative nausea, retching and vomiting up to 24 h after the end of anaesthesia. Droperidol 10μg.kg ‐1 was used as a “rescue” antiemetic. Results : The main result was that the patients in the propofol group did not suffer from retching and vomiting (R&V) during the first 6 h, whereas these symptoms occurred in 46% ( P <0.001) of the patients in the thiopentone group. The patients in the propofol group needed significantly less droperidol during the first 24 h (mean number of doses 0.39 ± 0.57 (SD)) than the patients in the thiopentone group (1.35 ± 1.47, P <0.005). Treatment with propofol was a predictor for lowered incidence of R&V, as well as male gender and negative history of motion sickness. Conclusion : Propofol at a subhypnotic dose of 0.5 mg.kg ‐1 provides prophylaxis against retching and vomiting for the first 6 h postoperatively after middle ear surgery. The incidence of nausea was not reduced by propofol.