ADJUVANT PROPOFOL ENABLES BETTER CONTROL OF NAUSEA AND EMESIS SECONDARY TO CHEMOTHERAPY FOR BREAST-CANCER

We investigated the prophylactic antiemetic effect of added low-dose o f propofol in patients exhibiting nausea and vomiting refractory to de xamethasone and serotonin antagonist during non-cisplatin chemotherapy for breast cancer. In a prospective open longitudinal study, 117 pati ents who had more than five episodes of nausea and vomiting in their f irst chemotherapy cycle during the first 24 hr completed the study. Th ey received in addition to the usual prophylactic antiemetic regimen a continous intravenous infusion of 1 mg . kg(-1). hr(-1) propofol star ted four hours before chemotherapy and continued up to 24 hr for the t wo subsequent cycles. The number of vomiting/nausea episodes, level of sedation, patient activity, appetite and preference for future chemot herapy cycles were assessed. In the propofol supplemented cycles 90 an d 80% of patients, during the 1st and 2nd propofol-assisted cycle resp ectively, were free of nausea and vomiting during the first 24 hr. aft er chemotherapy. Patients were more frequently active and had more app etite during the propofol-assisted cycles. No propofol-associated side effects were observed. We conclude that the addition of a subhypnotic infusion of propofol enables better control of nausea and vomiting ca used by non-cisplatin chemotherapy in the first 24 hr post-treatment.