Antiemetic activity of propofol after sevoflurane and desflurane anesthesia for outpatient laparoscopic cholecystectomy

Dajun Song, Charles W. Whitten, Paul F. White, Song Y. Yu, Eduardo Zarate

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: Controversy exists regarding the effectiveness of propofol to prevent postoperative nausea and vomiting. This prospective, randomized, single-blinded study was designed to evaluate the antiemetic effectiveness of 0.5 g/kg propofol when administered intravenously after sevoflurane- compared with desflurane-based anesthesia. Methods: Two hundred fifty female outpatients undergoing laparoscopic cholecystectomy were assigned randomly to one of four treatment groups. All patients were induced with intravenous doses of 2 mg midazolam, 2 μg/kg fentanyl, and 2 mg/kg propofol and maintained with either 1-4% sevoflurane (groups 1 and 2) or 2-80/0 desflurane (groups 3 and 4) in combination with 65% nitrous oxide in oxygen. At skin closure, patients in groups 1 and 3 were administered 5 ml intravenous saline, and patients in groups 2 and 4 were administered 0.5 mg/kg propofol intravenously. Recovery times were recorded from discontinuation of anesthesia to awakening, orientation, and readiness to be released home. Postoperative nausea and vomiting and requests for antiemetic rescue medication were evaluated during the first 24 h after surgery. Results: Propofol, in an intravenous dose of 0.5 mg/kg, administered at the end of a sevoflurane-nitrous oxide or desflurane-nitrous oxide anesthetic prolonged the times to awakening and orientation by 40-80% and 25-30%, respectively. In group 2 (compared with groups 1, 3, and 4), the incidences of emesis (22% compared with 47%, 53%, and 47%) and requests for antiemetic rescue medication (19% compared with 42%, 50%, and 47%) within the first 6 h after surgery were significantly lower, and the time to home-readiness was significantly shorter in duration (216 ± 50 min vs. 249 ± 49 min, 260 ± 88 min, and 254 ± 72 min, respectively). Conclusions: A subhypnotic intravenous dose of propofol (0.5 mg/kg) administered at the end of outpatient laparoscopic cholecystectomy procedures was more effective in preventing postoperative nausea and vomiting after a sevoflurane-based (compared with a desflurane-based) anesthetic.

Original languageEnglish (US)
Pages (from-to)838-843
Number of pages6
JournalAnesthesiology
Volume89
Issue number4
DOIs
StatePublished - Oct 1998

Fingerprint

Antiemetics
Laparoscopic Cholecystectomy
Propofol
Outpatients
Anesthesia
Postoperative Nausea and Vomiting
Nitrous Oxide
Anesthetics
Midazolam
Fentanyl
Vomiting
desflurane
sevoflurane
Oxygen
Skin
Incidence

Keywords

  • Anesthetics
  • Gases
  • Intravenous
  • Postoperative emesis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Antiemetic activity of propofol after sevoflurane and desflurane anesthesia for outpatient laparoscopic cholecystectomy. / Song, Dajun; Whitten, Charles W.; White, Paul F.; Yu, Song Y.; Zarate, Eduardo.

In: Anesthesiology, Vol. 89, No. 4, 10.1998, p. 838-843.

Research output: Contribution to journalArticle

Song, Dajun ; Whitten, Charles W. ; White, Paul F. ; Yu, Song Y. ; Zarate, Eduardo. / Antiemetic activity of propofol after sevoflurane and desflurane anesthesia for outpatient laparoscopic cholecystectomy. In: Anesthesiology. 1998 ; Vol. 89, No. 4. pp. 838-843.
@article{c802701ebfaa4113999a6a12249ff29d,
title = "Antiemetic activity of propofol after sevoflurane and desflurane anesthesia for outpatient laparoscopic cholecystectomy",
abstract = "Background: Controversy exists regarding the effectiveness of propofol to prevent postoperative nausea and vomiting. This prospective, randomized, single-blinded study was designed to evaluate the antiemetic effectiveness of 0.5 g/kg propofol when administered intravenously after sevoflurane- compared with desflurane-based anesthesia. Methods: Two hundred fifty female outpatients undergoing laparoscopic cholecystectomy were assigned randomly to one of four treatment groups. All patients were induced with intravenous doses of 2 mg midazolam, 2 μg/kg fentanyl, and 2 mg/kg propofol and maintained with either 1-4{\%} sevoflurane (groups 1 and 2) or 2-80/0 desflurane (groups 3 and 4) in combination with 65{\%} nitrous oxide in oxygen. At skin closure, patients in groups 1 and 3 were administered 5 ml intravenous saline, and patients in groups 2 and 4 were administered 0.5 mg/kg propofol intravenously. Recovery times were recorded from discontinuation of anesthesia to awakening, orientation, and readiness to be released home. Postoperative nausea and vomiting and requests for antiemetic rescue medication were evaluated during the first 24 h after surgery. Results: Propofol, in an intravenous dose of 0.5 mg/kg, administered at the end of a sevoflurane-nitrous oxide or desflurane-nitrous oxide anesthetic prolonged the times to awakening and orientation by 40-80{\%} and 25-30{\%}, respectively. In group 2 (compared with groups 1, 3, and 4), the incidences of emesis (22{\%} compared with 47{\%}, 53{\%}, and 47{\%}) and requests for antiemetic rescue medication (19{\%} compared with 42{\%}, 50{\%}, and 47{\%}) within the first 6 h after surgery were significantly lower, and the time to home-readiness was significantly shorter in duration (216 ± 50 min vs. 249 ± 49 min, 260 ± 88 min, and 254 ± 72 min, respectively). Conclusions: A subhypnotic intravenous dose of propofol (0.5 mg/kg) administered at the end of outpatient laparoscopic cholecystectomy procedures was more effective in preventing postoperative nausea and vomiting after a sevoflurane-based (compared with a desflurane-based) anesthetic.",
keywords = "Anesthetics, Gases, Intravenous, Postoperative emesis",
author = "Dajun Song and Whitten, {Charles W.} and White, {Paul F.} and Yu, {Song Y.} and Eduardo Zarate",
year = "1998",
month = "10",
doi = "10.1097/00000542-199810000-00007",
language = "English (US)",
volume = "89",
pages = "838--843",
journal = "Anesthesiology",
issn = "0003-3022",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Antiemetic activity of propofol after sevoflurane and desflurane anesthesia for outpatient laparoscopic cholecystectomy

AU - Song, Dajun

AU - Whitten, Charles W.

AU - White, Paul F.

AU - Yu, Song Y.

AU - Zarate, Eduardo

PY - 1998/10

Y1 - 1998/10

N2 - Background: Controversy exists regarding the effectiveness of propofol to prevent postoperative nausea and vomiting. This prospective, randomized, single-blinded study was designed to evaluate the antiemetic effectiveness of 0.5 g/kg propofol when administered intravenously after sevoflurane- compared with desflurane-based anesthesia. Methods: Two hundred fifty female outpatients undergoing laparoscopic cholecystectomy were assigned randomly to one of four treatment groups. All patients were induced with intravenous doses of 2 mg midazolam, 2 μg/kg fentanyl, and 2 mg/kg propofol and maintained with either 1-4% sevoflurane (groups 1 and 2) or 2-80/0 desflurane (groups 3 and 4) in combination with 65% nitrous oxide in oxygen. At skin closure, patients in groups 1 and 3 were administered 5 ml intravenous saline, and patients in groups 2 and 4 were administered 0.5 mg/kg propofol intravenously. Recovery times were recorded from discontinuation of anesthesia to awakening, orientation, and readiness to be released home. Postoperative nausea and vomiting and requests for antiemetic rescue medication were evaluated during the first 24 h after surgery. Results: Propofol, in an intravenous dose of 0.5 mg/kg, administered at the end of a sevoflurane-nitrous oxide or desflurane-nitrous oxide anesthetic prolonged the times to awakening and orientation by 40-80% and 25-30%, respectively. In group 2 (compared with groups 1, 3, and 4), the incidences of emesis (22% compared with 47%, 53%, and 47%) and requests for antiemetic rescue medication (19% compared with 42%, 50%, and 47%) within the first 6 h after surgery were significantly lower, and the time to home-readiness was significantly shorter in duration (216 ± 50 min vs. 249 ± 49 min, 260 ± 88 min, and 254 ± 72 min, respectively). Conclusions: A subhypnotic intravenous dose of propofol (0.5 mg/kg) administered at the end of outpatient laparoscopic cholecystectomy procedures was more effective in preventing postoperative nausea and vomiting after a sevoflurane-based (compared with a desflurane-based) anesthetic.

AB - Background: Controversy exists regarding the effectiveness of propofol to prevent postoperative nausea and vomiting. This prospective, randomized, single-blinded study was designed to evaluate the antiemetic effectiveness of 0.5 g/kg propofol when administered intravenously after sevoflurane- compared with desflurane-based anesthesia. Methods: Two hundred fifty female outpatients undergoing laparoscopic cholecystectomy were assigned randomly to one of four treatment groups. All patients were induced with intravenous doses of 2 mg midazolam, 2 μg/kg fentanyl, and 2 mg/kg propofol and maintained with either 1-4% sevoflurane (groups 1 and 2) or 2-80/0 desflurane (groups 3 and 4) in combination with 65% nitrous oxide in oxygen. At skin closure, patients in groups 1 and 3 were administered 5 ml intravenous saline, and patients in groups 2 and 4 were administered 0.5 mg/kg propofol intravenously. Recovery times were recorded from discontinuation of anesthesia to awakening, orientation, and readiness to be released home. Postoperative nausea and vomiting and requests for antiemetic rescue medication were evaluated during the first 24 h after surgery. Results: Propofol, in an intravenous dose of 0.5 mg/kg, administered at the end of a sevoflurane-nitrous oxide or desflurane-nitrous oxide anesthetic prolonged the times to awakening and orientation by 40-80% and 25-30%, respectively. In group 2 (compared with groups 1, 3, and 4), the incidences of emesis (22% compared with 47%, 53%, and 47%) and requests for antiemetic rescue medication (19% compared with 42%, 50%, and 47%) within the first 6 h after surgery were significantly lower, and the time to home-readiness was significantly shorter in duration (216 ± 50 min vs. 249 ± 49 min, 260 ± 88 min, and 254 ± 72 min, respectively). Conclusions: A subhypnotic intravenous dose of propofol (0.5 mg/kg) administered at the end of outpatient laparoscopic cholecystectomy procedures was more effective in preventing postoperative nausea and vomiting after a sevoflurane-based (compared with a desflurane-based) anesthetic.

KW - Anesthetics

KW - Gases

KW - Intravenous

KW - Postoperative emesis

UR - http://www.scopus.com/inward/record.url?scp=0031658333&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031658333&partnerID=8YFLogxK

U2 - 10.1097/00000542-199810000-00007

DO - 10.1097/00000542-199810000-00007

M3 - Article

C2 - 9778000

AN - SCOPUS:0031658333

VL - 89

SP - 838

EP - 843

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 4

ER -