A patient with a history of severe postoperative nausea and vomiting is scheduled for minor gynaecological surgery under general anaesthesia. Which intrinsic property of propofol supports its selection as the induction agent in this patient?

• A It reduces gastric acidity through H2 receptor antagonism
• B It blocks dopamine receptors in the chemoreceptor trigger zone
• C It suppresses the vomiting centre via mu-opioid receptors
• D It produces reliable antiemesis independent of hypnotic depth ✓

Explanation

Propofol has an intrinsic antiemetic effect; even subhypnotic boluses of about 10 to 20 mg reduce established nausea and vomiting in the recovery room. The exact mechanism is uncertain but is not dopamine blockade, since propofol is not a dopamine antagonist like droperidol. This property, together with smooth recovery, makes propofol the preferred agent when PONV risk is high. Gastric acid reduction plays no part in its profile.

Reference: Morgan and Mikhail's Clinical Anesthesiology, 7th ed.

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