The Comparision of Antiemetic Effects of Propofol, Ondansetron, Droperidol and Metoclopramide in Patients Undergoing Middle Ear Surgery

Abstract

Background: This study was designed to compare the antiemetic effects of propofol, ondansetron, droperidol and metoclopramide for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing middle ear surgery.Methods: One-hundred-twenty patients were scheduled for middle ear surgery (tympanomastoidectomy and tympanoplasty). Patients received propofol (0.5 mg/kg), ondansetron (60μg/kg), droperidol (20μg/kg) or metoclopramide (0.2 mg/kg) intravenously at the end of the surgical procedure. The assesment of PONV was performed during 3 periods after receiving anesthesia; 0 to 2 hours in the postanesthetic care unit, 2 to 12 hours and 12 to 24 hours in the ward.Results: The percentage of no emesis during the 0 to 2 hour period after receiving anesthesia was 93% for the those who received propofol, 73% for the those who received ondansetron, 70% for the those who received droperidol, and 70% for the those who received metoclopramide. The respective corresponding incidence during the 2 to 12 hour period after receiving anesthesia was 86%, 66%, 63%, and 63%, and the respective corresponding incidence during the 12-24 hour period after receiving anesthesia was 90%, 66%, 66%, and 66%. No clinically adverse events were observed in any of the groups.Conclusions: A small dose of propofol is a better antiemetic than ondansetron, droperidol or metoclopramide for prevention of postoperative nausea and vomiting after middle ear surgery.