Korean J Anesthesiol.  1998 May;34(5):984-990. 10.4097/kjae.1998.34.5.984.

Effects of Propofol-Fentanyl and Propofol-Ketorolac Anesthesia on Postoperative Nausea and Vomiting after Strabismus Surgery in Children

• Kil HK
• Kim WO
• Lee JB
• Hong JY
• Kim ME

• KMID: 2237661
• DOI: http://doi.org/10.4097/kjae.1998.34.5.984

Abstract

BACKGROUND: Strabismus surgery is associated with a high incidence of postoperative nausea and vomiting. Propofol is an anesthetic which has an antiemetic effect. A randomized study was done to compare the efficacy of propofol-fentanyl and propofol-ketorolac anesthesia for strabismus surgery in children.
METHODS
Eighty-five children, ASA physical status I or II, for strabismus surgery, were studied. Patients were randomly assigned to one of two groups by picking the envelop. Preanesthetic medication was not given. Fentanyl group received fentanyl 1.5 microgram/kg i.v. and ketorolac group received ketorolac 1 mg/kg, 2 minutes before induction. Atropine was given after that. Anesthesia was induced with propofol 2.4 mg/kg and vecuronium 1 mg/kg and intubation was performed. Anesthesia was maintained with a three-stage infusion technique of propofol (12 mg/kg/hr for 1st 10 minutes, 9 mg/kg/hr for 2nd 10 minutes and 6 mg/kg/hr was followed) with oxygen and nitrous oxide. Ketorolac was injected intramuscularly for preemptive analgesia immediate after induction. The incidence of nausea and vomiting was evaluated for postoperative 48 hours. And also, intraoperative oculocardiac reflex was monitored to compare the difference between two groups.
RESULTS
During postoperative 48 hours, fentanyl group and ketorolac group had a similar low incidence of nausea and vomiting (4.2% and 7.0%). There is no significant difference of intraoperative oculocardiac reflex between two groups (45.2% and 30.2%).
CONCLUSIONS
Propofol administered to induce and maintain anesthesia with a three-stage infusion technique is equally effective in preventing postoperative nausea and vomiting in propofol-fentanyl and propofol-ketorolac anesthesia for strabismus surgery in children.

Keyword

Anesthetics, intravenous: fentanyl, ketorolac, propofol; Complications: oculocardiac reflex, postoperative nausea and vomiting; Surgery, ophthalmologic: strabismus surgery

MeSH Terms

Analgesia
Anesthesia*
Antiemetics
Atropine
Child*
Fentanyl
Humans
Incidence
Intubation
Ketorolac
Nausea
Nitrous Oxide
Oxygen
Postoperative Nausea and Vomiting*
Preanesthetic Medication
Propofol
Reflex, Oculocardiac
Strabismus*
Vecuronium Bromide
Vomiting
Antiemetics
Atropine
Fentanyl
Ketorolac
Nitrous Oxide
Oxygen
Propofol
Vecuronium Bromide