• Y Fujii, H Tanaka, and N Kobayashi.
• Department of Anesthesiology, Toride Kyodo General Hospital, Toride City, Japan.
• Arch Otolaryngol. 2001 Jan 1;127(1):25-8.

ObjectiveTo 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.DesignProspective, randomized, double-blind study.SettingUniversity-affiliated teaching hospital.PatientsNinety patients (48 females, 42 males) scheduled for middle ear surgery.InterventionPatients 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.Main Outcome MeasureEmetic 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.ResultsThe 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.ConclusionA small dose of propofol is a better antiemetic than droperidol or metoclopramide for the prevention of postoperative nausea and vomiting after middle ear surgery.

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