Pe. Scuderi et al., SMALL-DOSE PROPOFOL BY CONTINUOUS-INFUSION DOES NOT PREVENT POSTOPERATIVE VOMITING IN FEMALES UNDERGOING OUTPATIENT LAPAROSCOPY, Anesthesia and analgesia, 84(1), 1997, pp. 71-75
This study was designed to test the hypothesis that there is a direct
prophylactic antiemetic effect of small-dose propofol given-by continu
ous infusion. Sixty female patients undergoing outpatient laparoscopy
under general anesthesia were randomized to receive, in a double-blind
fashion, either a bolus of 0.1 mg/kg followed by a constant infusion
of 1 mg . kg(-1). h(-1) of propofol or an equivalent volume of 10% Int
ralipid((R)) (placebo) beginning 30 min before induction of anesthesia
and continuing until discharge from Stage I postanesthesia care unit
(PACU). Anesthesia was induced and maintained in a standard fashion in
all patients. The number of emetic episodes before and after discharg
e from PACU, nausea scores (11-point numerical scale), and time to dis
charge were evaluated. No significant differences between Intralipid((
R)) and propofol were found for any of the outcome variables tested. W
hile small-dose propofol is an effective adjuvant in reducing chemothe
rapy-induced emesis, we were unable to demonstrate any beneficial effe
ct of propofol in reducing postoperative nausea and vomiting when used
as the sole prophylactic medication in this patient population. Propo
fol may have a synergistic effect when administered with other antieme
tics, or the specific antiemetic effect of propofol, if it exists, may
be dose-dependent and the dose used in this study was below the effic
acy threshold.