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.