Antiemetic efficacy of a droperidol-morphine combination in patient-controlled analgesia

To add or not to add? An empirical study on droperidol and intravenous patient-controlled analgesia

“…Droperidol is a highly potent dopamine D2 antagonist with well-proven antiemetic properties at an intravenous dose as low as 0.625e1.25 mg. 22 The antiemetic effect of droperidol may be dose-dependent, and its action may last from 6 to 12 hours. 16,24 Therefore, it is suggested that a repeated bolus of small doses should be considered to achieve the best antiemetic effect. 25,26 The addition of droperidol to the IVPCA regimen was regarded as a convenient way to extend its antiemetic effect over time.…”

“…25,26 The addition of droperidol to the IVPCA regimen was regarded as a convenient way to extend its antiemetic effect over time. 6,16 Some studies have accessed the benefit of combining an initial loading dose of droperidol with a small supplemental dose of droperidol delivered by an IVPCA device. 5,7,9,16,23 Lamond et al have demonstrated that droperidol (0.10 mg/ mL) combined with morphine (1 mg/mL) in the IVPCA container is the optimal dose for preventing PONV.…”

“…Ludwin and Shafer, however, suggested that the FDA was justified in placing a warning on a drug that was linked to potentially harmful adverse effects, although the label should be clarified. 15 Although some clinical trials have proven the efficacy and safety of low-dose droperidol for management of PONV, 5,9,16,17 the clinical settings vary from study to study, and it is questionable whether the results from controlled trials can be satisfactorily generalized to routine clinical practice in different settings. After reviewing the literature above, we initiated a month-long clinical investigation in August 2008 to evaluate the ramifications of discontinuing droperidol in the IVPCA regimen as a pilot study to confirm whether droperidol is a necessary adjuvant for IVPCA.…”

Patient-controlled analgesia combined with either ondansetron or ondansetron plus prochlorperazine for control of pain and nausea and vomiting in patients undergoing abdominal surgery

“…In several reports, droperidol decreased vomiting without affecting nausea. However, another report showed that droperidol reduced both nausea and vomiting when used with PCA [7].…”

“…Antiemetics evaluated include propofol, metoclopramide, ondansetron, tropisetron, prochlorperamide, and droperidol [5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In several reports, droperidol decreased vomiting without affecting nausea.…”