Which IV anesthetic agent is associated with the highest incidence of postoperative nausea and vomiting?

Which IV anesthetic agent is associated with the highest incidence of postoperative nausea and vomiting?

• A. Thiopental
• B. Etomidate
• C. Ketamine
• D. Propofol

Answer: (B)

Postoperative nausea and vomiting risk varies with the IV induction agent because some agents have intrinsic antiemetic effects while others do not and can contribute to nausea. Propofol stands out for its antiemetic properties, which lowers PONV risk. Among the agents listed, etomidate lacks this antiemetic effect and is more often associated with postoperative nausea and vomiting, making it more emetogenic than the others in this group. Thiopental generally has a neutral or milder emetogenic profile, and ketamine can cause PONV in some patients, but etomidate tends to have the highest incidence among these options. Overall, PONV is multifactorial, but the absence of antiemetic influence with etomidate explains its association with more postoperative nausea and vomiting.

Postoperative nausea and vomiting risk varies with the IV induction agent because some agents have intrinsic antiemetic effects while others do not and can contribute to nausea. Propofol stands out for its antiemetic properties, which lowers PONV risk. Among the agents listed, etomidate lacks this antiemetic effect and is more often associated with postoperative nausea and vomiting, making it more emetogenic than the others in this group. Thiopental generally has a neutral or milder emetogenic profile, and ketamine can cause PONV in some patients, but etomidate tends to have the highest incidence among these options. Overall, PONV is multifactorial, but the absence of antiemetic influence with etomidate explains its association with more postoperative nausea and vomiting.