Comparison of Droperidol, Haloperidol and Prochlorperazine as Postoperative Anti-Emetics

Loeser, Edward A.; Bennett, Gary J.; Stanley, T. H.; Machin, R.

doi:10.1097/00132586-198002000-00032

Cited by 3 publications

(4 citation statements)

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“…Although the numbers involved in these studies were small, it would appear that anti-emetics were relatively ineffective in treating PONV, a finding that is in agreement with at least one other comparative study. 14 We suggest that for the purposes of setting standards of care for acute pain services it is important to focus on the incidence of PONV after major surgery only. The overall incidence of PONV for an acute pain service will reflect the balance between the use of the three postoperative analgesic techniques, and incidence may vary slightly between acute pain services.…”

Section: Discussionmentioning

confidence: 99%

Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritis, and urinary retention. Evidence from published data

Dolin

Cashman

2005

British Journal of Anaesthesia

180

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This review examines the evidence from published data concerning the tolerability (indicated by the incidence of nausea, vomiting, sedation, pruritus, and urinary retention), of three analgesic techniques after major surgery; intramuscular analgesia (i.m.), patient-controlled analgesia (PCA), and epidural analgesia. A MEDLINE search of publications concerned with the management of postoperative pain and these indicators identified over 800 original papers and reviews. Of these, data were extracted from 183 studies relating to postoperative nausea and vomiting, 89 relating to sedation, 166 relating to pruritus, and 94 relating to urinary retention, giving pooled data which represent a total of more than 100,000 patients. The overall mean (95% CI) incidence of nausea was 25.2 (19.3-32.1)% and of emesis was 20.2 (17.5-23.2)% for all three analgesic techniques. PCA was associated with the highest incidence of nausea but the emesis was unaffected by analgesic technique. There was considerable variability in the criteria used for defining sedation. The overall mean for mild sedation was 23.9 (23-24.8)% and for excessive sedation was 2.6 (2.3-2.8)% for all three analgesic techniques (significantly lower with epidural analgesia). The overall mean incidence of pruritus was 14.7 (11.9-18.1)% for all three analgesic techniques (lowest with i.m. analgesia). Urinary retention occurred in 23.0 (17.3-29.9)% of patients (highest with epidural analgesia). The incidence of nausea and excessive sedation decreased over the period 1980-99, but the incidence of vomiting, pruritus, and urinary retention did not. From these published data it is possible to set standards of care after major surgery for nausea 25%, vomiting 20%, minor sedation 24%, excessive sedation 2.6%, pruritus 14.7%, and urinary retention requiring catheterization 23%. Acute Pain Services should aim for incidences less than this standard of care.

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Section: Discussionmentioning

confidence: 99%

Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritis, and urinary retention. Evidence from published data

Dolin

Cashman

2005

British Journal of Anaesthesia

180

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“…They may be utilized for the prevention of post-operative nausea and vomiting as well. The dual use of butyrophenones is exemplified by neuroleptic drugs like haloperidol, the most widely used classical antipsychotic drug in this class, is a key tranquilizing drug, with substantial antiemetic activity due to its dopamine D 2 receptor antagonist properties [259]. Unfortunately, sideeffects [260] such as drowsiness, dysphoria, delayed discharge, extrapyramidal reactions, restlessness, and anxiety after discharge have led to the refusal to use these drugs in the outpatient setting.…”

Section: 32mentioning

confidence: 99%

Dopamine receptors in emesis: Molecular mechanisms and potential therapeutic function

Belkacemi

Darmani

2020

Pharmacological Research

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“…Die Phenothiazine Promethazin und Chlorpromazin finden seit Jahren Anwendung für die Prophylaxe und Therapie postoperativer Emesis [61]. Ihre antiemetische Wirksamkeit wird auf Blockade zentraler Dopaminrezeptoren zurückgeführt.…”

Section: Phenothiazineunclassified

“…Ihre antiemetische Wirksamkeit wird auf Blockade zentraler Dopaminrezeptoren zurückgeführt. Da Phenothiazine jedoch neuroleptische Eigenschaften haben, ist nach ihrer Gabe mit Nebenwirkungen wie Dysphorie, Sedation und Lethargie zu rechnen [46,61]. Ein Phenothiazin mit geringerer sedativer Komponente, Dixyrazin, konnte erfolgreich bei Strabismuskorrekturen zur Emesisprophylaxe bei Kindern eingesetzt werden.…”

Section: Phenothiazineunclassified

Postoperative Nausea und Emesis: Mechanismen und Behandlung

Unkel¹,

Peters²

1998

Anästhesiol Intensivmed Notfallmed Schmerzther

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The incidence of postoperative emetic symptoms in patients varies between 3 and 91%. Nausea and emesis remain the most common as well as unpleasant side-effects experienced by patients following general anaesthesia, both in the ambulatory and non-ambulatory care setting. Furthermore, emesis carries the risk of severe postoperative complications and is associated with additional costs. Multiple factors are associated with an increased risk of developing postoperative nausea and emesis including age, gender, weight, preexisting disease, as well as anaesthetic and surgical procedures. Routine antiemetic prophylaxis is not currently advisable in patients with a low Emesis Risk, due to undesirable side-effects of antiemetics and additional costs. However, anti-emetic prophylaxis is recommended for patients with an increased risk. Besides administration of antiemetics, other factors that may provoke postoperative emesis need to be considered such as gastric distension, early mobilisation, insufficient analgesia, choice of anaesthetic drugs. High-risk patients may be anaesthetized with propofol, if possible. If symptoms do develop in the recovery room, tight fitting oxygen masks should be avoided and adequate hydration and analgesia ensured. To avoid side effects, antiemetics should be administered in minimally effective dosages. If emesis persists, combination of antiemetic drugs with different profiles of receptor action may be particularly useful.

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Comparison of Droperidol, Haloperidol and Prochlorperazine as Postoperative Anti-Emetics

Cited by 3 publications

References 0 publications

Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritis, and urinary retention. Evidence from published data

Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritis, and urinary retention. Evidence from published data

Dopamine receptors in emesis: Molecular mechanisms and potential therapeutic function

Postoperative Nausea und Emesis: Mechanismen und Behandlung

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