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

McKenzie, Ray; Tantisira, Boonrak; Jackson, Douglas; Bach, Tina; Riley, Theodore J.

doi:10.1016/0952-8180(95)90047-0

Cited by 5 publications

(8 citation statements)

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“…incidence and frequency of vomiting with the addition of either droperidol 0.016 or 0.033 mg.mg -1 PCA morphine, although this benefit may have resulted due to the very small loading dose used (0.5 mg). 13 Our study confirmed that a preoperative droperidol bolus of 1.0 mg reduces the incidence and frequency of vomiting compared with placebo, but that further reduction could not be obtained from the addition of droperidol to PCA morphine. Considering that the sample size of the study was calculated for the primary endpoint of severity of nausea, it is possible that an insufficient number of subjects was studied to demonstrate a significant difference in vomiting between the groups.…”

Section: Discussionsupporting

confidence: 74%

“…lj,t2 In addition, most of these studies found further reductions in PONV when a single perioperative droperidol bolus of greater than 1.0 mg was supplemented with PCA droperidol in doses as low as 0.05 mg. mg -I morphine. 9-~ McKenzie et al 13 used the lowest doses published to date. He evaluated a reduced perioperative loading dose of 0.5 mg with and without PCA droperidol doses of 0.016 or 0.033 mg.mg -I morphine.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 1996

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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

et al. 1996

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“…Adverse effects, including drowsiness and extrapyramidal disorder, increased in the droperidol group, although there were no statistically significant differences between the groups in this respect (Table 4). The patients in the droperidol group had higher IVPCA rescue dose use (14 times [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] ) than the control group (P < 0.001). The pain scores were lower at all times in the droperidol group than in the control group.…”

Section: Resultsmentioning

confidence: 99%

Droperidol Reduces Postoperative Nausea and Vomiting and Supports the Continuation of Intravenous Patient-Controlled Analgesia with Fentanyl

et al. 2020

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PURPOSE: To examine the impact of adding droperidol to fentanyl-based intravenous patient-controlled analgesia (IVPCA) on the discontinuation of IVPCA use due to postoperative nausea and vomiting (PONV). METHODS: Patients who underwent surgeries other than abdominal surgeries and used IVPCA between April 2014 and March 2018 were selected. Patients using IVPCA with fentanyl alone were compared to patients using droperidol added to IVPCA. Patients were allocated to one of two groups depending on the drug used for IVPCA: 1) control group, fentanyl alone; 2) droperidol group, droperidol with fentanyl. The primary endpoint was the discontinuation of IVPCA due to PONV. Secondary endpoints included PONV within 48 hours after surgery, the number of antiemetics used, pain score, and adverse effects. Propensity score matching was used to control the differences in clinical features among patients. RESULTS: Among the 793 patients initially enrolled in this study, 145 were excluded via propensity score matching; 364 of the remaining patients received IVPCA supplemented with droperidol. Propensity score matching showed that discontinuation of IVPCA due to PONV was significantly decreased in the droperidol group compared to the control group (P = 0.01). Further, compared with the control group, the droperidol group had reduced nausea up to 24 hours after surgery (P < 0.01), and the number of vomiting episodes and use of antiemetics decreased within 12 hours after surgery (P < 0.01). CONCLUSIONS: The addition of droperidol to IVPCA is associated with a decrease in PONV, as well as the improved continuation of pain treatment with fentanyl-based IVPCA, similar to IVPCA with morphine. However, it is necessary to monitor the side effects of this treatment.

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“…1 Several investigators have prescribed droperidol in combination with patient-controlled morphine. 1,19 Although effective in reducing vomiting, droperidol increased the level of sedation. 19 We have used a combination of patient-controlled morphine and ondansetron for postoperative pain and emesis.…”

Section: Neurosurg Focus / Volume 12 / May 2002mentioning

confidence: 99%

“…1,19 Although effective in reducing vomiting, droperidol increased the level of sedation. 19 We have used a combination of patient-controlled morphine and ondansetron for postoperative pain and emesis. Preliminary comparisons with patient-controlled morphine therapy alone demonstrate reduced pain, nausea, and higher satisfaction with this combination patient-controlled therapy.…”

Section: Neurosurg Focus / Volume 12 / May 2002mentioning

confidence: 99%

Perioperative management of complex skull base surgery: the anesthesiologist's point of view

Jellish¹,

Murdoch²,

Jp³

2002

FOC

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The anesthetic management of complex skull base surgical procedures provides unique problems and concerns for the neuroanesthesiologist. Positioning to access the skull base could put the patient at risk for peripheral nerve injury and some of the positions may increase the risk for air emboli. In addition, tumor pathology and involvement with vital structures could increase the chances for substantive blood loss, destruction of associated nerves or vessels, and may require temporary occlusion of the carotid artery necessitating intraoperative neuroprotection. Neurophysiological monitors may also be used to safeguard nerve function and anesthetic techniques must be adjusted to accommodate their use. Finally, postoperative morbidity may be affected by surgical approach to the skull base and the anesthesiologist should be aware of which approach may produce a greater incidence of pain, nausea, and vomiting in the postoperative period. The authors discuss the anesthetic concerns and management for complex cranial base surgery. Different approaches will be discussed and comparisons of perioperative parameters between these approaches will be made with data provided by retrospective chart review of more than 600 skull base procedures performed at the authors' institution over the last 10 years. This information should help guide decision making concerning anesthetic management for these skull base procedures.

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

Cited by 5 publications

References 0 publications

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

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

Droperidol Reduces Postoperative Nausea and Vomiting and Supports the Continuation of Intravenous Patient-Controlled Analgesia with Fentanyl

Perioperative management of complex skull base surgery: the anesthesiologist's point of view

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