Subhypnotic propofol does not treat postoperative vomiting in children after adenotonsillectomy.
OBJECTIVE
To investigate the efficacy of a subhypnotic dose of propofol to treat vomiting in children after adenotonsillectomy.


METHODS
Two hundred and fifty-two children, aged 2-12 yr, underwent a standardized anaesthetic opioid administration, and postoperative care after adenotonsillectomy, adenoidectomy or tonsillectomy. A prospective, double-blinded, placebo-controlled study was performed in 70 of the patients who retched or vomited after surgery and who had intravenous access. Patients were assigned randomly to receive either 0.2 mg.kg-1) propofol (n = 35), or placebo (intralipid 10%, n = 35).


RESULTS
The overall incidence of vomiting during the first 18-24 hr was 50%. Of those who had received propofol after the first episode of vomiting, 63% relapsed requiring a rescue antiemetic compared with 57% of those who had received intralipid (P = NS). Of the children who received propofol, 54% experienced pain on injection and 46% were mildly sedated compared with 3% and 11%, respectively, in the placebo group (P < 0.003).


CONCLUSIONS
We conclude that an intravenous bolus of 0.2 mg.kg-1 propofolis not effective in the treatment of postoperative vomiting in children after adenotonsillectomy when a standardized anaesthetic with thiopentone, halothane, nitrous oxide, and 1.5 mg.kg-1 codeine phosphate is used, but it does cause sedation and pain on injection.
Zestos
M M
MM
Department of Anaesthesia, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Carr
A S
AS
McAuliffe
G
G
Smith
H S
HS
Sikich
N
N
Lerman
J
J
D000233:Adenoidectomy / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003061:Codeine / Q000008:administration & dosage; D004311:Double-Blind Method; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D006221:Halothane / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015994:Incidence; D007275:Injections, Intravenous / Q000009:adverse effects; D009609:Nitrous Oxide / Q000008:administration & dosage; D010146:Pain / Q000209:etiology; D010919:Placebos; D011183:Postoperative Complications / Q000188:drug therapy*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D012008:Recurrence; D013874:Thiopental / Q000008:administration & dosage; D014068:Tonsillectomy / Q000009:adverse effects*; D014839:Vomiting / Q000188:drug therapy*
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000932:Antiemetics; D005217:Fat Emulsions, Intravenous; D006993:Hypnotics and Sedatives; D010919:Placebos; D013874:Thiopental; D009609:Nitrous Oxide; D006221:Halothane; D003061:Codeine; D015742:Propofol