Prevention of postoperative nausea and vomiting with antiemetics in patients undergoing middle ear surgery: comparison of a small dose of propofol with droperidol or metoclopramide.
OBJECTIVE
To compare the efficacy and safety of a small dose of propofol with other commonly used antiemetics, droperidol and metoclopramide, for the prevention of postoperative nausea and vomiting in patients undergoing middle ear surgery.


METHODS
Prospective, randomized, double-blind study.


METHODS
University-affiliated teaching hospital.


METHODS
Ninety patients (48 females, 42 males) scheduled for middle ear surgery.


METHODS
Patients received propofol, 0.5 mg/kg, droperidol, 20 microg/kg, or metoclopramide hydrochloride, 0.2 mg/kg, intravenously at the end of the surgical procedure. A standardized general anesthetic technique was employed throughout the surgical procedure.


METHODS
Emetic episodes and safety assessment were performed during 2 periods-0 to 3 hours in the postanesthetic care unit and 3 to 24 hours in the ward-after receiving anesthesia.


RESULTS
The incidence of patients who were emesis free during the 0- to 3-hour period after receiving anesthesia was 93% for those who received propofol, 73% for those who received droperidol, and 70% for those who received metoclopramide, respectively; the respective corresponding incidence during the 3- to 24-hour period after receiving anesthesia was 90%, 67%, and 60% (P<.05, overall Fisher exact probability test). No clinically adverse events were observed in any of the groups.


CONCLUSIONS
A small dose of propofol is a better antiemetic than droperidol or metoclopramide for the prevention of postoperative nausea and vomiting after middle ear surgery.
Fujii
Y
Y
Department of Anesthesiology, Toride Kyodo General Hospital, Toride City, Japan.
Tanaka
H
H
Kobayashi
N
N
D000328:Adult; D000704:Analysis of Variance; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004329:Droperidol / Q000008:administration & dosage / Q000627:therapeutic use*; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*
D000932:Antiemetics; D008787:Metoclopramide; D004329:Droperidol; D015742:Propofol