Propofol Infusion and the Incidence of Emesis in Pediatric Outpatient Strabismus Surgery

Abstract

A prospective, randomized, double-blind study was conducted to examine the effect of a propofol infusion on the incidence of postoperative emesis in children undergoing outpatient strabismus surgery. Seventy-eight children, aged 3-12 yr, were allocated randomly to receive either nitrous oxide and halothane or nitrous oxide and a propofol infusion for the maintenance of anesthesia. The overall incidence of vomiting during the first 24 h was 64% in those receiving halothane and 41% in those receiving the propofol infusion; this difference was statistically significant (P < 0.05). In children who received no opioids postoperatively, the incidence of vomiting in the first 24 h was 71% in the halothane group and 24% in the propofol group; this difference was also significant (P = 0.001). We conclude that propofol was effective in reducing the incidence of postoperative emesis in pediatric outpatient strabismus surgery.

Propofol anaesthesia and vomiting after myringoplasty in children

“…Our clinical experience is that intra-operative opioid is needed for acceptable analgesia after myringoplasty. Intra-operative opioids increased the incidence of vomiting in children having strabismus surgery under propofol anaesthesia [2]. However, the omission of opioid from our anaesthetic technique would neither be appropriate nor allow our study to give clinically relevant results.…”

“…It also reduces vomiting in children after strabismus surgery and tonsillectomy [2,3] and avoids the extrapyramidal side-effects associated with some anti-emetic agents. Nausea and vomiting after ear surgery is a common problem in children and anti-emetic agents are neither entirely effective nor without side-effects [4,5].…”

“…Enfants, 6, rue Willy Donze, 1211 Geneve 14, Switzerland Accepted: 22 December 1996 Propofol anaesthesia is associated with rapid recovery and a decreased incidence of postoperative nausea and vomiting when compared with inhalational anaesthesia [1]. It also reduces vomiting in children after strabismus surgery and tonsillectomy [2,3] and avoids the extrapyramidal side-effects associated with some anti-emetic agents. Nausea and vomiting after ear surgery is a common problem in children and anti-emetic agents are neither entirely effective nor without side-effects [4,5].…”

Propofol decreases cerebral blood flow velocity in anesthetized children

“…This was based on a pediatric pharmacokinetic model designed to target an estimated steady-state serum propofol concentration of 3 µg·mL -1 . 2 Thirty minutes were allowed for steady state to be reached, at which point three measurements of Vmca, heart rate (HR) and mean arterial pressure (MAP) were taken at one-minute intervals. In order to double the estimated serum propofol concentration, another 2.5 mg·kg -1 of propofol was given, and the infusion was doubled to 22 mg·kg -1 ·hr -1 .…”

“…Its use is characterized by rapid clearance and distribution, resulting in rapid emergence from anesthesia, 1 and decreased nausea and vomiting. 2 Propofol is a suitable agent for neuroanesthesia in adult patients 3 and is gaining popular- Propofol decreases cerebral blood flow velocity in anesthetized children ity in the pediatric population. 4 The increase in popularity of iv techniques for neuroanesthesia in children results from potentially undesirable cerebral vasodilatory effects of the volatile anesthetic agents at higher concentrations.…”