Comparison of droperidol, haloperidol and prochlorperazine as postoperative anti-emetics

Abstract

PROCHLORPERAZINE (Compazine) has been used for many years as a post-operative anti-emetic. Recent reports have shown that the butyrophenones, droperidol and haloperidol, also have anti-emetic properties.t-5 This study was undertaken to compare the effectiveness of droperidol, haloperidol and prochlorperazine with a placebo, normal saline, as post-operative anti-emetics in patients who began to vomit in the recove,'y room early after operation. METHODS This investigation was approved by the University of Utah Hospital Human Experimentation Committee. Sixty-five post-operative patients, who had previously given informed written consent for inclusion in the study and who had one or more episodes of vomiting in the recovery room, were the experimental subjects. All patients received pentobarbitone (50-100rag) or diazepam (5-10rag), atropine (0.2-0.5 rag) and meperid ine (50-100 rag) or morphine (5-10 rag), intramuscularly for premedication 90 minutes before arrival in the operating room. Anaesthesia was induced with sodium thiopentone 4 mg. kg-t intravenously and the trachea was intubated after paralysis with intravenous succinylcholine 1.5 rag-kg-I. Anaesthesia was maintained with halothane (0.5-2.0 per cent) or enflurane (1-3 per cent) and nitrous oxide (60 per cent) in oxygen. Paralysis was maintained with increments of pancuronium 1-3 mg intravenously for general surgical, gynaecological, or orthopedic operations. Patients included in the study were those who vomited one or more times in the recovery room, Immediately after the vomiting episode, the experimental subjects were given a two milliliter intramuscular injection of the contents of an unlabeled, numbered vial. The

Prevention of nausea and vomiting during termination of pregnancy

“…The antiemetic activity of butyrophenones is a result of their antagonistic properties at the dopamine receptor [25]. By blocking dopaminergic receptors, benzamides have an antiemetic action in the central nervous system (in the chemoreceptor trigger zone of the medulla and the vomiting center in the area postrema of the brain) and in the gastrointestinal tract.…”

Impact of a multimodal anti‐emetic prophylaxis on patient satisfaction in high‐risk patients for postoperative nausea and vomiting

“…The plasma half life of haloperidol is longer and thus the drug probably has a longer duration of action, even when administered in low doses such as 0.5-0.75 mg. However, there is limited data on the anti-emetic efficacy and potential side-effects of haloperidol in the PONV setting [19][20][21] and future studies will have to validate the equivalence of the drug compared with droperidol. However, droperidol was still used as part of the rescue treatment of PONV in the recovery room and on the ward due to persisting standards and in order to avoid confusion in routine postoperative care of the patients.…”

Nalbuphine and droperidol in combination for sedation and prevention of nausea and vomiting during intra-carotid BCNU infusion

“…The substitution of droperidol for diazepam is based upon the antiemetic properities of droperidol (9,15,16) without the respiratory depression occasionally associated with intravenous diazepam (17). Droperidol has an antiemetic potency approximately 800 times greater than that of thorazine (23).…”