Vomiting after alfentanil anesthesia: effect of dosing method

Abstract

This double-blind study correlated the association of nausea and vomiting after alfentanil with its method of administration (bolus dose vs continuous infusion). Of 40 women undergoing lower abdominal gynecologic or laparoscopic surgery, 20 received an intravenous alfentanil (30 micrograms/kg) bolus dose for induction of anesthesia, with subsequent bolus doses of 10 micrograms/kg every 10 min, and 20 received the same induction dose delivered over 1 min, followed by an intravenous infusion at 1.0 micrograms.kg-1.min-1. The infusion group experienced more frequent nausea and vomiting than the bolus dose group (50% vs 30%, respectively; P = 0.0001). Laparoscopic surgery affected the incidence of nausea and vomiting independently of the method of alfentanil administration (75% for laparoscopic vs 17% for incisional procedures; P = 0.0001). Laparoscopy and alfentanil infusion combined synergistically to worsen the incidence of nausea and vomiting. We conclude that alfentanil infusion for laparoscopic surgery entails a high risk for nausea and vomiting.