Addition of droperidol to patient‐controlled analgesia: effect on nausea and vomiting

Abstract

SummaryA double-blind trial of the effect of droperidol on the incidence of nausea and vomiting in patients using patient-controlled analgesia was carried out in 60 healthy women undergoing abdominal hysterectomy. After a standard anaesthetic including droperidol 2.5 mg as a prophylactic antiemetic, patients were randomly allocated to receive postoperative patient-controlled analgesia with either morphine alone ( 2 mg.ml-') or morphine ( 2 mg.rn1-') with droperidol (0.2 mg.ml-')

Reduction of post-operative nausea and vomiting with the combination of morphine and dropéridol in patient-controlled analgesia

“…The VAS has been validated for assessment of nausea in antiemetic trials of oncology patients receiving chemotherapy, 24 and adopted for use in the postoperative setting. 9 Williams et al used a VAS to assess severity of nausea with PCA droperidol and found similar results to the present study with mean scores less than 2 out of 10 in both groups. 9 Despite the small range of scores documented by both of these studies, statistically significant reductions in severity were identified with the addition of droperidol to PCA morphine.…”

“…The population that we studied would appear to be an accurate sample as the placebo group had a 71% incidence of vomiting which is similar to that previously documented in women undergoing gynaecological surgery. 3 '4 In a similar population to the present study, Williams et al 9 found a reduction in the incidence of nausea at 12 hr and a reduction in its severity at both 12 and 24 hr when droperidol 0.10 mg.mg -~ PCA morphine was used after a bolus of 2.5 mg at the time of induction. Sharma et al ~~ used lower doses and demonstrated a 50% overall reduction in the incidence of nausea over 24 hr, while Barrow et al H established a reduction in the number of four-hourly assessments during which nausea occurred.…”

A Randomized Comparison of Droperidol, Metoclopramide, Tropisetron, and Ondansetron for the Prevention of Postoperative Nausea and Vomiting

“…Khail et al [24] found droperidol (0.075 mg/kg) effective in PONV prophylaxis during strabismus surgery in children. Williams et al [25] applied patient-controlled analgesia with morphine in patients who had abdominal hysterectomies and in the treatment of postoperative pain; they reported that droperidol was effective in preventing PONV. Gan et al [14] found droperidol and patient-controlled analgesia effective in preventing PONV after orthopedic surgery; these results were similar to those found after gynecologic operations [26,27].…”

Nausea and vomiting in the postoperative patient‐controlled analgesia environment

“…However, Silverman et al [42] found the inclusion of promethazine with morphine PCA reduced nausea although the findings were dependent on the nausea scale used. Studies have found that the addition of droperidol (0.05-0.2 mg.ml ÿ 1 ) to morphine PCA has reduced the incidence of nausea and vomiting and, in some cases, the need for additional intramuscular anti-emetics [5,9,40,43,44]. However, some studies reported an increase in sedation associated with the use of droperidol [5,9,44] and Gan et al [45] argued that adding droperidol to PCA increases sedation with no benefit over a single dose of droperidol at the end of surgery.…”

“…Studies have found that the addition of droperidol (0.05-0.2 mg.ml ÿ 1 ) to morphine PCA has reduced the incidence of nausea and vomiting and, in some cases, the need for additional intramuscular anti-emetics [5,9,40,43,44]. However, some studies reported an increase in sedation associated with the use of droperidol [5,9,44] and Gan et al [45] argued that adding droperidol to PCA increases sedation with no benefit over a single dose of droperidol at the end of surgery. Moreover, although extrapyramidal side-effects were not reported in any of the studies, they should be considered, particularly if PCA is to continue beyond 24 h. Collum et al [46] report a case study of a patient experiencing a dystonic reaction Ϸ30 h after surgery and while receiving PCA morphine with droperidol 0.2 mg.ml ÿ 1 added.…”