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Subhypnotic propofol does not treat postoperative vomiting in children after adenotonsillectomy

1997; Springer Science+Business Media; Volume: 44; Issue: 4 Linguagem: Inglês

10.1007/bf03014461

1496-8975

Maria M. Zestos, Alison Carr, Georgina McAuldiffe, Helen S. Smith, Nancy Sikich, Jerrold Lerman,

Anesthesia and Pain Management

To investigate the efficacy of a subhypnotic dose of propofol to treat vomiting in children after adenotonsillectomy. 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 propofol (n = 35). or placebo (intralipid 10%, n = 35). The overall incidence of vomiting during the first 18–24 hr was 50%. Of those who had received propofol after the fust 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% expenenced pain on injection and 46% were mildly sedated compared with 3% and 11%, respectively, in the placebo group (P< 0.003). We conclude that an intravenous bolus of 0.2 mg·kg−1 propofol is 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.