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  • Title: Reduction of emetic symptoms during cesarean delivery with antiemetics: propofol at subhypnotic dose versus traditional antiemetics.
    Author: Numazaki M, Fujii Y.
    Journal: J Clin Anesth; 2003 Sep; 15(6):423-7. PubMed ID: 14652118.
    Abstract:
    STUDY OBJECTIVE: To evaluate the efficacy and safety of propofol (at a subhypnotic dose), droperidol, and metoclopramide in reducing emetic symptoms during cesarean delivery. DESIGN: Randomized, double-blinded, placebo-controlled study. SETTING: University hospital. PATIENTS: 100 ASA physical status I and II parturients undergoing cesarean delivery with spinal anesthesia. INTERVENTIONS: Patients received placebo (saline) followed by placebo (Intralipid(R)), placebo (saline) followed by propofol at a subhypnotic dose (1.0 mg/kg/hr), droperidol 1.25 mg followed by placebo (Intralipid(R)), or metoclopramide 10 mg followed by placebo (Intralipid(R)) intravenously (IV) immediately after clamping of the umbilical cord. MEASUREMENT AND MAIN RESULTS: The percentage of patients who were emesis-free, which was defined as experiencing no nausea, retching, or vomiting, in the intraoperative, postdelivery period was 80% with propofol, 80% with droperidol, and 78% with metoclopramide (p < 0.05), compared with placebo (40%). Severity of nausea was less inpatients who received propofol than in those who received placebo (p < 0.05), and there were no differences seen among the droperidol, metoclopramide, and placebo groups. No clinically serious adverse events as a result of the study drugs were observed in any of the groups. CONCLUSIONS: Prophylactic antiemetic efficacy of propofol at a subhypnotic dose (1.0 mg/kg/hr), droperidol 1.25 mg, and metoclopramide 10 mg is comparable in parturients undergoing cesarean delivery. Moreover, propofol at a subhypnotic dose is effective in the prevention of severe nausea.
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