- Design
- Single-centre randomised controlled trial
- Population
- 102 women with Apfel score 3 or more having gynaecological laparoscopy
- Primary outcome
- Nausea and vomiting within 6 hours
- Effect
- 5.9% fospropofol vs 19.6% propofol (absolute reduction 13.7%, P = .038)
A randomised trial in Drug Design, Development and Therapy (19 September 2026) gave 102 women at high risk of postoperative nausea and vomiting (Apfel score 3 or more) either fospropofol or propofol for induction and maintenance, alongside sevoflurane, for gynaecological laparoscopy.
Nausea and vomiting in the first six hours fell from 19.6% with propofol to 5.9% with fospropofol, an absolute reduction of 13.7 percentage points. Rates in recovery and at 24 hours did not differ. Extubation took a median 4 minutes longer with fospropofol, and recovery-room pain was less common.
This is one small single-centre trial with a narrow time window for benefit. Fospropofol's availability in India is unknown. The trial is a reminder, though, that a propofol-based technique still leaves one in five high-risk women nauseated, so multimodal prophylaxis remains the standard.
- Assess Apfel risk for every patient and give prophylaxis in proportion.
- Use multimodal antiemetic prophylaxis in high-risk patients, whatever the hypnotic.
- Treat fospropofol as investigational for this purpose pending larger trials.
- Expect slightly slower extubation if fospropofol is used.
Why it matters
Even with propofol, one in five high-risk women was sick early, so the prophylaxis bundle still matters.
Don't overread it
A single small trial, with the benefit confined to the first six hours.
The statistics, in plain English
With 51 patients a group, the difference rests on 3 versus 10 events, so the true size of the effect is uncertain. The wide confidence interval on the odds ratio (0.045 to 0.809) reflects that.
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