Antiemetic effect of propofol administered at the end of surgery in laparoscopic assisted vaginal hysterectomy

Abstract

BackgroundPostoperative nausea and vomiting (PONV) commonly occur after general anesthesia, especially in women. In this study, we evaluated the antiemetic efficacy of propofol administered at the end of surgery in highly susceptible patients undergoing a laparoscopy-assisted vaginal hysterectomy.MethodsA total of 107 women undergoing a laparoscopy-assisted vaginal hysterectomy under general anesthesia were enrolled for this prospective, double-blind, randomized study. Fifteen minutes before the end of surgery, all patients received 50 µg fentanyl and 1 of following 3 doses; 0.5 mg/kg of propofol (propofol 0.5 group), 1 mg/kg of propofol (propofol 1.0 group), and normal saline (control group). All patients received intravenous patient-controlled analgesia (PCA). Emergence time, a visual analog scale for pain and nausea, duration of postanesthesia care unit (PACU) stay, and frequency of antiemetic use were recorded at 0-2, 2-24, and 24-48 hours postoperatively.ResultsThe incidence of nausea significantly lower in the propofol 0.5 and propofol 1.0 groups than in the control group (12.1 vs 14.7 vs 40%). During the first postoperative 2 hours, antiemetics were less frequently administered in the propofol 0.5 and propofol 1.0 groups than in the control group (3.0 vs 5.9 vs 22.5%). Emergence time was slightly longer in the propofol 0.5 and propofol 1.0 groups than in the control group, but there was no significant difference in PACU stay time was observed between the 3 groups.ConclusionsThe results of this study suggest that low-dose propofol administration at the end of surgery may effectively reduce the incidence of PONV within 2 hours postoperatively in highly susceptible women undergoing a laparoscopiy-assisted vaginal hysterectomy and receiving opioid-based PCA.

Effect of Body Mass Index on Postoperative Nausea and Vomiting: Propensity Analysis

“…However, there is no correlation between CYP activity and BMI [50]. The pharmacokinetics of propofol, which is frequently used for anesthesia induction, are not affected by obesity [42]; moreover, propofol has antiemetic activity [56].…”

Sub-hypnotic dose of propofol as antiemetic prophylaxis attenuates intrathecal morphine-induced postoperative nausea and vomiting, and pruritus in parturient undergoing cesarean section — a randomized control trial

“…In a study by Song et al [16] it was demonstrated that propofol given after sevoflurane and desflurane anesthesia for outpatient laparoscopic cholecystectomy significantly decreased the incidence of PONV compared with control. Similarly, reports suggest that low-dose of propofol (0.5 or 1 mg/kg) administration at the end of surgery effectively reduce the incidence of PONV within 2 h postoperatively in highly susceptible women undergoing a laparoscopy-assisted vaginal hysterectomy and receiving opioid-based PCA [21]. In this present study, it was realized that 105 (91.30%) from the propofol group experienced no incidence of PONV compared with 7 (6.09%) parturient from the control group, a similar observation Chatterjee et al [22], Apfel et al [23] and Warltier et al [24] have also earlier submitted.…”

Anti-emetic Drugs for Prophylaxis of Postoperative Nausea and Vomiting After Craniotomy: An Updated Systematic Review and Network Meta-Analysis

“…Finally, the included trials contain differences that could potentially influence outcomes. Propofol has been reported to have anti-emetic properties (5,32), and propofol combined with volatile anesthesia is related to lower PON incidence (33). Some data from the included studies used propofol as an anesthetic method.…”