Effect of Propofol on Postoperative Nausea and Vomiting.
Condition: Postoperative Nausea and Vomiting
MeSH terms: Nausea; Vomiting; Postoperative Nausea and Vomiting
Study type: Interventional
Phase: Phase 4

Summary: 
      As PONV is an unpleasant experience that badly affects the patients' quality of life after
      surgery and the anti-emetic effects of propofol have been seldomly studied in Pakistan, this
      study aims at investigation of the beneficial effects of propofol in reducing the occurrence
      of PONV.
    

Detailed description: 
      Cesarean Section is one of the most commonly performed surgical procedures in the obstetric
      patients. Adequate intra and postoperative analgesia is very important in providing comfort
      to the mother, early breastfeeding, ambulation and discharge as well as enhancing patient
      satisfaction.Spinal anesthesia is widely accepted as the anesthesia of choice for cesarean
      section owing to its safety and speed. PONV is an unpleasant condition, often underestimated
      side effect of anesthesia and surgery, quite common in women undergoing spinal anesthesia for
      cesarean.It is one of the significant problems in Post Anaesthesia Care Units. The etiology
      of PONV is multifactorial with patient factors (gender, history of motion sickness, age),
      intra Op factors (type of anesthesia, surgery and opioid use) and post Op factors (pain, post
      Op opioid use) which are found to be associated with the PONV. Apfel simplified scoring is
      based on four independent factors including female gender, non-smoker, history of PONV or
      motion sickness and use of opioids. Each predictor is given a score of 1. A score of 0,1,2,3
      or 4 predicts the chance of developing PONV as approximately 10%, 20%, 40% or 80%.

      The intense efforts accompanying emesis increase the risk of complications such as wound
      dehiscence, bleeding, aspiration pneumonitis, dehydration, electrolyte imbalance and
      interference with nutrition. While it is difficult to completely avoid the occurrence of
      PONV, it can be markedly reduced using a multimodal non-opioid analgesia, total intravenous
      anesthesia and adequate prophylactic antiemetic premedication. Propofol has been reported to
      have anti-emetic effects at sub hypnotic dose as a bolus or a continuous infusion in
      susceptible individuals undergoing surgeries, though the exact mechanism of this effect is
      yet to be discovered.

      In a research published in BMC Anesthesiology, the data indicates a significant difference in
      the incidence of PONV in control group (93.9%) and the study group (8.7%) with a single sub
      hypnotic dose of propofol administered 10-15 min before the end of surgery in parturients
      undergoing cesarean section under spinal anaesthesia.
    

Intervention name(s): Propofol; saline 0.9%
Intervention type(s): Drug; Drug
Intervention description(s): Antiemetic effect of propofol; Placebo
Other intervention name(s): propofol injection; normal saline
Intervention MeSH terms: Propofol
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized clinical trial
Masking: Single (Participant)
Primary purpose: Other
Keywords: postoperative nausea and vomiting, propofol