DOES PROPOFOL REDUCE VOMITING AFTER STRABISMUS SURGERY IN CHILDREN

Background: Previous studies have indicated that propofol anaesthesia may reduce the incidence of postoperative nausea and vomiting after st rabismus surgery in children. This study was designed to investigate t he incidence of vomiting after strabismus surgery at two different lev els of propofol anaesthesia compared to thiopental/isoflurane anaesthe sia. Methods: Ninety ASA class I or II children, aged 5-14 yrs were ra ndomly assigned to one of three groups: Group T/I (n=30) induction wit h 5 mg kg(-1) of thiopental and maintenance with isoflurane, group P5 (n=31) induction with propofol 2 mg kg(-1) maintenance with propofol i nfusion 5 mg kg(-1) h(-1) or group P10 (n=29) induction with propofol 2 mg kg(-1), maintenance with propofol 10 mg kg(-1) h(-1). All receive d glycopyrrolate, vecuronium, fentanyl and controlled ventilation with O-2/N2O 30/70. Ketorolac i.v. , was given to prevent postoperative pa in. If additional analgesia was needed, ibuprofen/acetaminophen or bup renorphine was given according to clinical need. Results: There were n o differences between study groups with respect to age, weight, histor y of previous anaesthesia or emesis after previous anaesthesia, durati on of anaesthesia, surgery or sleep after anaesthesia, or number of mu scles operated. The incidence of vomiting was 37%, 29% and 28% in grou ps T/I, P5 and P10, respectively There were no statistically significa nt differences between the three groups in the incidence of vomiting. The median age of patients who vomited was 7.5 (range 5.0-13.7) yrs wh ile the median age of the patients who did not vomit was 9.1 (range 5. 0-14.0) yrs (P<0.01). Conclusion: In the present study, propofol anaes thesia compared to thiopental/isoflurane anaesthesia did not reduce th e incidence of vomiting following strabismus surgery in children.