Effect of propofol on the incidence of postoperative vomiting after strabismus surgery in pediatric outpatients

Vomiting is a common problem after strabismus surgery in pediatric outpatients. We compared the effects of propofol with and without N₂O and droperidol to the effects of a conventional regimen consisting of halothane-N₂O-droperidol on the recovery characteristics and the incidence of postoperative emesis after strabismus surgery in 120 ASA physical status 1 or 2 children. After induction of anesthesia with halothane-N₂O, patients were randomly assigned to one of four groups. Group A (control) received halothane, 66% N₂O, and droperidol 75 μg·kg^-1; group B, propofol 2 mg·kg^-1 bolus followed by infusion of 160 μg·kg^-1·min^-1; group C, propofol (as in group B) and 66% N₂O; and group D, propofol (as in group B), 66% N₂O (as in group C), and droperidol 75 μg·kg^-1. Patients in group B had more episodes of intraoperative oculocardiac reflex responses than patients in group A, but had shorter times to extubation, oral intake, ambulation, and discharge, as well as a lower incidence of postoperative emesis (P < 0.05). The addition of N₂O to the propofol anesthetic regimen (group C) was associated with an increased incidence of emesis (P < 0.05), whereas the addition of droperidol to the propofol-N₂O regimen (group D) did not affect the incidence of emesis compared to the other three groups. We conclude that maintenance of anesthesia with a total intravenous regimen using propofol results in a more rapid recovery and less postoperative emesis than with a halothane-N₂O-droperidol regimen.