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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
Yoshitaka Fujii, MD;
Hiroyoshi Tanaka, MD;
Noriaki Kobayashi, MD
Arch Otolaryngol Head Neck Surg. 2001;127:25-28.
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.
Design Prospective, randomized, double-blind study.
Setting University-affiliated teaching hospital.
Patients Ninety patients (48 females, 42 males) scheduled for middle ear surgery.
Intervention Patients received propofol, 0.5 mg/kg, droperidol, 20 µg/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.
Main Outcome Measure 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.
Conclusion 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.
From the Department of Anesthesiology (Drs Fujii and Tanaka) and Otolaryngology
(Dr Kobayashi), Toride Kyodo General Hospital, Toride City, Japan.
Corresponding author: Yoshitaka Fujii, MD, Department of Anesthesiology,
University of Tsukuba Institute of Clinical Medicine, 2-1-1 Amakubo, Tsukuba
City, Ibaraki 305, Japan.
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