Haloperidol versus Haloperidol plus Ondansetron for the Prophylaxis of Postoperative Nausea and Vomiting after Ophthalmologic Surgery

Abstract

Introduction: In this prospective, randomized, and double-blinded study we investigated the efficacy of haloperidol (10 μg/kg) and the combination of haloperidol (10 μg/kg) with ondansetron (0.1 mg/kg) for the prophylaxis of postoperative nausea and vomiting (PONV) after ophthalmologic surgery. Methods: 60 patients (ASA status 1–3) with risk factors for PONV (female, non-smoker, motion sickness or PONV in history, opioids for postoperative analgesia) undergoing retinal or strabismus surgery were included into the study and randomised to the haloperidol group (H-Group) or the haloperidol-ondansetron group (H/O-Group). 20 min before the end of anaesthesia the study medication was given. Nausea, vomiting, pain scores, and adverse events were assessed postoperatively over 24 h. Results: The incidence of PONV was lower for the H/O-Group (23 vs. 57% for the H-Group). Especially the incidence of vomiting was reduced for the H/O-Group (7 vs. 27% in the H-Group). No significant differences could be detected regarding adverse events. Conclusion: The single use of haloperidol for the prophylaxis of PONV is doubtful. Better results were obtained with the combination therapy of haloperidol with ondansetron, especially for vomiting.

Low Doses of Haloperidol Combined With Ondansetron Are not Effective for Prophylaxis of Postoperative Nausea and Vomiting in Susceptible Patients

“…In the O&Hal1 group, 42% (CI: 32-53) of patients suffered from EE vs 20% (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), 25% (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) and 30% in groups O&Dex, O&Hal2 and O&Dro respectively (P=.005). These significant differences were observed in groups O&Dex and O&Hal1 from the 6 to 12 h interval ( Table 2).…”

“…[27][28][29][30] Various studies using haloperidol 1 mg have shown that it is effective 15,28,31,32 but other studies have not achieved the same results. 33,34 Even so, clinical guidelines recommend the use of haloperidol 1 or 2 mg in combination. 8,27,35,36 In the studies that showed haloperidol to be effective, patients were either not high-risk or were not observed for a sufficient length of time.…”

Manual de práctica clínica basado en la evidencia: Controles posquirúrgicos

“…La combinación de 2 medicamentos antieméticos es efectiva en la profilaxis de náusea y vómito postoperatorio (evidencia categoría A2-B), sin diferencias en los efectos secundarios como cefalea, mareo, somnolencia e inquietud 24,31,32,48,53,56,[68][69][70][71][72][73][74][75][76][77] .…”

Postoperative Nausea and Vomiting in Cancer Surgery: Present Views on the Solution of the Old Problem

“…В ряде исследований доказано наличие противорвотной активности галоперидола, эффективность которого сопоставима с ондансетроном и особенно высока в их комбинации [41]. Недо статком является кратковременность действия -3 часа [1].…”