Effect of continuous infusion of a subhypnotic dose of propofol on nausea and vomiting after carboprost administration at cesarean delivery: A randomized, double-blind, placebo-controlled trial

Objective To investigate whether continuous infusion of propofol at a subhypnotic dose prevents nausea and vomiting following carboprost administration at cesarean delivery. Methods A prospective, randomized, double-blind, placebo-controlled trial conducted at West China Second University Hospital, from June 28, 2017 to January 30, 2018. Pregnant women were randomly allocated to propofol or saline infusion immediately before receiving carboprost at cesarean delivery under combined spinal-epidural (CSE) anesthesia. Propofol was given at an infusion rate of 1.0 mg/kg/h following a loading dose of 0.3 mg/kg. Primary outcome was incidence of intraoperative nausea and vomiting (IONV). Potential sedative effect of propofol infusion was assessed using Modified Observer's Assessment of Alertness and Sedation (MOAA/S) scoring and continuous Bispectral Index (BIS) monitoring. Results The incidence of IONV was lower in patients who received propofol compared with saline (46.7% vs 76.7%, OR 0.27; 95% CI, 0.092-0.78, P = 0.016 for nausea; 26.7% vs 53.3%, OR 0.50; 95% CI, 0.25-0.95, P = 0.032 for retching; 10.0% vs 50.0%, OR 0.11; 95% CI, 0.03-0.44, P < 0.001 for vomiting). There were no differences in MOAA/S scoring or BIS between the two groups. Conclusion A subhypnotic dose of propofol reduces the incidence of nausea and vomiting following carboprost administration at cesarean delivery under CSE anesthesia, without measurable effect on patients' consciousness or alertness. ClincalTrials.gov: NCT03185156.