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Canadian Journal of Anaesthesia =... Jun 2000To estimate the efficacy and harm produced by droperidol in the prevention of postoperative nausea and vomiting (PONV). (Review)
Review
PURPOSE
To estimate the efficacy and harm produced by droperidol in the prevention of postoperative nausea and vomiting (PONV).
METHODS
Systematic search (MEDLINE, EMBASE, Cochrane library, hand-searching, bibliographies, all languages, up to May 1999) for randomised comparisons of droperidol with placebo in surgical patients. Relevant end points were prevention of early PONV (up to six hours postoperatively), and late PONV (24 hr), and adverse effects. Combined data were analysed using relative risk and NNT.
RESULTS
In 76 trials, 5,351 patients received 24 different regimens of droperidol. The average incidence of early and late PONV in controls was 34% and 51%, respectively. Droperidol was more efficacious than placebo in preventing PONV. In adults, the anti-nausea effect was short-lived, and there was no dose-responsiveness; with 0.25 to 0.30 mg the number-needed-to-treat (NNT) to prevent early nausea was 5. For both early and late anti-vomiting efficacy there was dose-responsiveness; best efficacy was with 1.5 mg to 2.5 mg (NNT, 7). In children, there was dose-responsiveness; best efficacy was with 75 microg x kg(-1) (NNT to prevent early and late vomiting, 4). Two children had extrapyramidal symptoms with droperidol (NNT in children, 91; in any patient, 408). There was dose-responsiveness for sedation and drowsiness (with 2.5 mg the NNT was 7.8). Droperidol prevented postoperative headache (NNT, -25).
CONCLUSIONS
Droperidol is anti-emetic in the surgical setting. The effect on nausea is short-lived but more pronounced than the effect on vomiting. Sedation and drowsiness are dose-dependent, extrapyramidal symptoms are rare, and there is a protective effect against headache.
Topics: Adult; Antiemetics; Child; Dose-Response Relationship, Drug; Droperidol; Humans; Postoperative Nausea and Vomiting
PubMed: 10875717
DOI: 10.1007/BF03018945 -
Clinical Neuropharmacology 1998There is little information in the literature concerning the use of droperidol in psychiatry. This article presents three cases in which extremely agitated and... (Review)
Review
There is little information in the literature concerning the use of droperidol in psychiatry. This article presents three cases in which extremely agitated and treatment-refractory persons with mixed mania derived benefit from droperidol administered orally. Symptomatic improvement, including decreased agitation and intrusiveness, improved sleep, and decreased rates of sleep, was observed with the use of oral droperidol at doses ranging from 10-80 mg daily. The only adverse reaction was a dystonia in one patient. This article also reviews the limited available literature on the use of droperidol in psychiatry. Only eight English language articles describing the use of droperidol for psychosis or agitation were found. Future controlled studies to examine the usefulness of oral dosing of droperidol in mania are suggested.
Topics: Administration, Oral; Adult; Antipsychotic Agents; Bipolar Disorder; Depression; Droperidol; Female; Humans; Male; Middle Aged
PubMed: 9789713
DOI: No ID Found -
Journal of Pharmacy & Pharmaceutical... 2020To examine the impact of adding droperidol to fentanyl-based intravenous patient- controlled analgesia (IVPCA) on the discontinuation of IVPCA use due to postoperative...
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.
Topics: Adjuvants, Anesthesia; Analgesia, Patient-Controlled; Cohort Studies; Droperidol; Female; Fentanyl; Humans; Male; Middle Aged; Postoperative Nausea and Vomiting; Retrospective Studies
PubMed: 32569560
DOI: 10.18433/jpps30902 -
Critical Care Nurse 1987
Topics: Droperidol; Humans; Nursing Care
PubMed: 3665555
DOI: No ID Found -
The Journal of Emergency Medicine Jul 2015Droperidol (Inapsine®, Glaxosmithkline, Brent, UK) is a butyrophenone used in emergency medicine practice for a variety of uses. QT prolongation is a well-known adverse... (Review)
Review
BACKGROUND
Droperidol (Inapsine®, Glaxosmithkline, Brent, UK) is a butyrophenone used in emergency medicine practice for a variety of uses. QT prolongation is a well-known adverse effect of this class of medications. Of importance to note, QT prolongation is noted with multiple medication classes, and droperidol increases QT interval in a dose-dependent fashion among susceptible individuals. The primary goal of this literature search was to determine the reported safety issues of droperidol in emergency department management of patients.
METHODS
A MEDLINE literature search was conducted from January 1995 to January 2014 and limited to human studies written in English for articles with keywords of droperidol/Inapsine. Guideline statements and nonsystematic reviews were excluded. Studies identified then underwent a structured review from which results could be evaluated.
RESULTS
There were 542 papers on droperidol screened, and 35 appropriate articles were rigorously reviewed in detail and recommendations given.
CONCLUSION
Droperidol is an effective and safe medication in the treatment of nausea, headache, and agitation. The literature search did not support mandating an electrocardiogram or telemetry monitoring for doses < 2.5 mg given either intramuscularly or intravenously. Intramuscular doses of up to 10 mg of droperidol seem to be as safe and as effective as other medications used for sedation of agitated patients.
Topics: Dopamine D2 Receptor Antagonists; Droperidol; Electrocardiography; Emergency Medicine; Emergency Service, Hospital; Headache; Humans; Nausea; Psychomotor Agitation; Societies, Medical
PubMed: 25837231
DOI: 10.1016/j.jemermed.2014.12.024 -
Emergency Medicine Australasia : EMA Apr 2021
Topics: Antipsychotic Agents; Conscious Sedation; Droperidol; Humans; Problem Behavior
PubMed: 33561901
DOI: 10.1111/1742-6723.13744 -
CMAJ : Canadian Medical Association... Sep 2002
Topics: Antiemetics; Droperidol; Electrocardiography; Humans; Postoperative Nausea and Vomiting; United States; United States Food and Drug Administration
PubMed: 12240805
DOI: No ID Found -
Anesthesiology Feb 2003
Topics: Antiemetics; Droperidol; Humans; Postoperative Nausea and Vomiting; Risk Assessment; United States; United States Food and Drug Administration
PubMed: 12552182
DOI: 10.1097/00000542-200302000-00002 -
Paediatric Anaesthesia Oct 2004
Topics: Antiemetics; Droperidol; Humans; United States; United States Food and Drug Administration
PubMed: 15385007
DOI: 10.1111/j.1460-9592.2004.01412.x -
Gastrointestinal Endoscopy Jun 2006Droperidol is a known effective adjunctive agent for sedation/analgesia during endoscopic procedures, particularly in patients who are difficult to sedate with narcotics...
BACKGROUND
Droperidol is a known effective adjunctive agent for sedation/analgesia during endoscopic procedures, particularly in patients who are difficult to sedate with narcotics and benzodiazepines alone. However, the Food and Drug Administration (FDA) warning about potential droperidol-related fatal cardiac arrhythmias, issued in December 2001, led to concern about its safety in current clinical practice.
OBJECTIVE
In this study, we evaluated the effects of droperidol on the Bazett's corrected QT interval (QTcB) administered to patients undergoing ERCP and frequency of cardiac arrhythmias.
DESIGN
We retrospectively reviewed the medical records of patients who, at our institute, underwent ERCP while under sedation/analgesia and who received droperidol. Our protocol for patients who are considered to be candidates for droperidol use includes obtaining an ECG before and 1 to 3 hours after the procedure.
RESULTS
From April 2002 to October 2004, 6292 ERCPs were performed, of which 3113 patients with normal baseline QTcB (2001 women, 1112 men) received droperidol. Mean dosages were 4.3 mg (range, 1.25-10 mg) in women and 4.5 mg (range, 1.25-13.75 mg) in men. A total of 233 patients (7.48%; 133 women, 100 men) developed QTcB prolongation. Mean increases of the QTcB above the upper limit of normal were 16 milliseconds in women (range, 1-194 milliseconds) and 22 milliseconds in men (range, 1-310 milliseconds). Of these, 15 patients (0.48%; 8 women, 7 men) had marked prolongation of the QTcB (defined QTcB, >500 milliseconds). No serious dysrhythmias occurred.
CONCLUSIONS
Droperidol at usual doses during sedation/analgesia may precipitate QTcB prolongation above the normal range. However, no QT-related arrhythmias were noted in this study. Clinically significant cardiac events are probably rare with droperidol, despite documented QTcB effects. Baseline electrocardiogram for excluding patients with prolonged baseline QTcB and 1 to 3 hours afterward monitoring appears adequate when using droperidol. The study is still too small to detect very infrequent arrhythmia events.
Topics: Adjuvants, Anesthesia; Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Cholangiopancreatography, Endoscopic Retrograde; Conscious Sedation; Droperidol; Electrocardiography; Female; Heart Conduction System; Humans; Male; Middle Aged; Retrospective Studies
PubMed: 16733113
DOI: 10.1016/j.gie.2006.01.052