Low dose propofol during cesarean section an effective anti-emetic

NEW YORK (Reuters Health) – A subhypnotic dose of 1-2 mg/kg per hour of propofol effectively controls the nausea and vomiting associated with regional anesthesia during cesarean section, Japanese researchers report.

Drs. Yoshitaka Fujii and Mitsuko Numazaki of the University of Tsukuba randomized 80 women undergoing cesarean section with spinal anesthesia to placebo or to one of three doses of propofol. The dosing in the three active treatment arms was 0.5 mg/kg per hour, 1.0 mg/kg per hour, or 2.0 mg/kg per hour.

Overall, 40% of patients on placebo were emesis-free compared with 45% of patients on propofol 0.5 mg/kg per hour and 80% of patients in each of the groups receiving 1.0 kg/mg per hour and 2.0 mg/kg per hour.

Sedation levels were comparable in all treatment groups, and all patients were awake within 5 minutes of drug discontinuation.

The Japanese team notes, in their study published in the January issue of Obstetrics and Gynecology, that compared with some drugs used to control emesis, such as droperidol and metoclopramide, subhypnotic doses of propofol lack adverse effects such as restlessness, dystonic reactions, extrapyramidal signs or excessive sedation.

Obstet Gynecol 2002;99:75-79.

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