Propofol Reduces Postoperative Vomiting in Children: Presented at ASA

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Title: Propofol Reduces Postoperative Vomiting in Children: Presented at ASA
URL: http://www.pslgroup.com/dg/2313EA.htm
Doctor's Guide
October 22, 2008

By Deborah Brauser

ORLANDO, Fla -- October 22, 2008 -- Propofol significantly decreases the incidence of postoperative vomiting (POV) in paediatric ophthalmology and otolaryngology patients, according to results presented here at the American Society of Anesthesiologists (ASA) 2008 Annual Meeting.

Koichi Suehiro, MD, Osaka City General Hospital and Children's Hospital, Osaka, Japan reported the results in a poster session on October 19.

The incidence of POV in children is reported to be twice as frequent as in adults, which can lead to serious complications, according to Dr. Suehiro. Therefore, his research team conducted their study to investigate not only the incidences of POV after paediatric surgery, but also the effectiveness of propofol during induction of anaesthesia for preventing POV.

The researchers reviewed data from 2,577 patients who underwent surgical procedures at the Osaka City Hospital over a 4-year period. Of these, 1,299 had ophthalmological procedures, which included strabismus repair (propofol use, n = 583; nonuse, n = 716); 558 had otolaryngological procedures, including tonsillectomy (propofol use, n =184; nonuse, n = 374); and 725 had general paediatric surgery, such as inguinal hernioplasty (propofol use, n = 138; nonuse, n = 587).

Anaesthesia was induced in each of these cases with either nitrous oxide-oxygen-sevoflurane (slow induction) or propofol at a dose of 2 to 3 mg/kg (rapid induction). Anaesthesia was maintained in all patients with nitrous oxide-oxygen-sevoflurane.

In the 3 days after surgery, rates of POV were 14.9% in the ophthalmology patients, 19.3% in the otolaryngology patients, and 5.7% in the general surgery patients. The incidence in ophthalmology and otolaryngology patients was significantly higher than that in general surgery patients (P < .001).

Analysis of the data by use of propofol for induction showed that there were significant reductions in POV in both the ophthalmology (8.6% vs 17.6%) and otolaryngology patients (9.8% vs 21.4%; P < .001 each). No significant difference was observed in the general surgery patients.

"This was a 4-year study with over 2,000 patients in our hospital," said Dr. Suehiro. "In these children subjects, using propofol for the induction of anaesthesia decreased POV after paediatric surgery. This is the most important message. It's just very effective and I'm very excited."

[Presentation title: Usefulness of Propofol for Preventing Postoperative Vomiting (POV) in Children. Abstract A-796]

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