Small dose of propofol for preventing nausea and vomiting after third molar extraction

Purpose: The study goal was to evaluate the efficacy and safety of a small dose of propofol for the prevention of nausea and vomiting following third molar extraction. Patients and Methods: In a prospective, randomized, double-blinded, placebo-controlled trial, 90 women received placebo or propofol at 2 different doses (0.25 mg/kg, 0.5 mg/kg) (n=30 of each) intravenously at the end of surgery. A standard general anesthestic technique, including sevoflurane and nitrous oxide in oxygen, was employed throughout the surgical procedure. Emetic episodes and safety assessments were performed during 0 to 3 hours and 3 to 24 hours after after anesthesia. Results: The rate of patients experiencing emesis-free (no nausea, retching, or vomiting) during 0 to 3 hours after anesthesia was 60% with placebo, 66% with propofol 0.25 mg/kg (P=.395), and 90% with propofol 0.5 mg/kg (P=.001); the corresponding rate during 3 to 24 hours after anesthesia was 60%, 63% (P=0.5), and 87% (P=.02) (P values compared with placebo). No clinically serious adverse effects due to the study drug were observed in any group. Conclusions: Prophylactic therapy with a small dose (0.5 mg/kg) of propofol is effective for preventing postoperative nausea and vomiting in female patients undergoing general anesthesia for third molar extractions. (C) 2002 American Association of Oral and Maxillofacial Surgeons.