Effect of Propofol Infusion on Need for Rescue Antiemetics in Postanesthesia Care Unit After Volatile Anesthesia: A Retrospective Cohort Study
Main findingResult — go to the resultOdds ratio 0.55 95% CI 0.49–0.61Authors' conclusion
The addition of propofol infusions to volatile-based anesthesia is associated with a dose-dependent reduction in the need for rescue antiemetics in the PACU regardless of the number of prophylactic antiemetics, duration of procedure, and type of volatile agent used, without affecting PACU recovery time.
Study context
- Population
- Adults undergoing procedures under GA with volatile agents, admitted to the postanesthesia care unit (PACU), May 2018 through December 2020
- Participants
- 47,847 adults
- Exposure
- Propofol infusion with volatile anesthesia vs pure volatile anesthesia
- Propofoln = 17,573
- No propofoln = 30,274reference
- Outcome
- Need for rescue antiemetics in the PACU
Methodological detailsinverse probability of treatment weighting
- Inverse probability of treatment weighting
Main finding
As reported in the abstract
Odds ratio
0.55
95% CI 0.49–0.61
P < 0.001
By group
Propofol vs No propofol
OR 0.55 (95% CI 0.49–0.61); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Ratio of the geometric mean (95% CI) | P value |
|---|---|---|
| PACU recovery timePropofol vs No propofol | 1.00 (0.98–1.01) | P = 0.56 |
| PACU recovery timeRescue antiemetics vs No antiemetics | 1.31 (1.28–1.33) | P < 0.001 |
Rescue antiemetics by intensity of antiemetic prophylaxis (subgroup)
- OR, 0-1 antiemetics
- 0.59
- OR, 2 antiemetics
- 0.51
- OR, ≥3 antiemetics
- 0.58
- All P <.001
Rescue antiemetics by procedural duration (subgroup)
- OR, ≤2.50 hours
- 0.54
- OR, 2.51-4.00 hours
- 0.62
- OR, ≥4.01 hours
- 0.47
- All P <.001
Rescue antiemetics by volatile agent (subgroup)
- OR, desflurane
- 0.51
- OR, isoflurane
- 0.52
- OR, sevoflurane
- 0.57
- All P <.001
Dose dependence
- Dose dependent effect, little additional benefit when propofol rate exceeded 100 μg/kg/min
Original publication
Effect of Propofol Infusion on Need for Rescue Antiemetics in Postanesthesia Care Unit After Volatile Anesthesia: A Retrospective Cohort Study. Anesth Analg. Published 21 February 2024. doi:10.
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