BACKGROUND: Postoperative nausea and vomiting (PONV) is a common complication of a gynecologic laparoscopy. This study was designed to assess the effect of prophylactic droperidol 1 mg or propofol as the induction and maintenance anesthetic agent for prophylaxis of PONV in women undergoing a gynecologic laparoscopy. METHODS: Eighty ASA physical status 1, 2 patients undergoing an elective gynecologic laparoscopy were randomly allocated into four groups. Group 1 (n = 20) recieved an intravenous placebo of noraml saline 1 ml prior to induction of anesthesia and N2O-enflurane general anesthesia. Group 2 (n = 20) recieved an intravenous placebo of noraml saline 1 ml prior to induction of anesthesia and N2O-propofol general anesthesia. Group 3 (n = 20) recieved intravenous prophylactic droperidol 1 mg prior to induction of anesthesia and N2O-enflurane general anesthesia. Group 4 (n = 20) recieved intravenous prophylactic droperidol 1 mg prior to induction of anesthesia and N2O-propofol general anesthesia. RESULTS: The incidence and severity of PONV and sedation scores were assessed at 0, 30 min, 1, 3, 6, 24 and 48 hours postoperatively. The incidence of PONV was 75% in group 1, 10% in group 2, 30% in group 3 and 20% in group 4. The incidence of PONV during the first 6 hours postoperatively was 70% in group 1, 0% in group 2, 10% in group 3 and 5% in group 4 and there were no statistical differences among the four groups in the 6 to 24 hour postoperative period. Sedation scores were significantly higher in group 3 and 4 than in 1 and 2 in the 3 to 6 hour postoperative period. CONCLUSIONS: Propofol anesthesia, prophylactic droperidol 1 mg and a combination to prevent PONV were highly effective during the first 6 hours postoperatively.