SUBHYPNOTIC DOSES OF PROPOFOL POSSESS DIRECT ANTIEMETIC PROPERTIES

Propofol is associated with a low incidence of postoperative nausea an d vomiting. In a prospective, randomized, double-blind, placebo-contro lled study, we investigated the possible direct antiemetic properties of a subhypnotic dose of propofol. Fifty-two ASA physical status I or II patients, aged 15-60 yr with nausea and vomiting after minor gyneco logic, orthopedic, or digestive tract surgery, were included in the st udy and received either propofol (10 mg = 1 mL) or placebo (1 mL Intra lipid) intravenously in the postanesthesia care unit. Patients treated with propofol experienced a larger reduction in nausea and vomiting t han patients treated with placebo (81% vs 35% success rate; P < 0.05). Patients successfully treated had a similar incidence of relapse (pro pofol 28%; placebo 22%) within the first 30 min after therapy. Thirty- three percent of the propofol-treated patients and 44% of the placebo- treated patients showed a minor increase in sedation. The level of pos toperative pain did not change in either group. Hemodynamic values rem ained unchanged in both groups. Pain on injection (7.6%) or dizziness (3.6%) only occurred in the propofol group. We conclude that propofol has significant direct antiemetic properties.