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Journal of Clinical Pharmacology Feb 1998A high-dose (0.75 to 2.8 mg/kg) pharmacokinetic study of droperidol was undertaken in patients during the recovery phase after cardiac surgery involving hypothermic...
A high-dose (0.75 to 2.8 mg/kg) pharmacokinetic study of droperidol was undertaken in patients during the recovery phase after cardiac surgery involving hypothermic cardiopulmonary bypass (CPB). The elimination half-life of droperidol in these patients, determined from concentration-time data obtained after CPB, was significantly prolonged relative to previously reported mean values in younger surgical patients not undergoing CPB and receiving lower doses of the drug (0.05-0.20 mg/kg). On stratification of the patients by droperidol dose, there was an inverse correlation between the size of the dose and the elimination half-life of droperidol: mean half-life decreased as mean dose increased. This difference in elimination half-life was not related to the duration of the CPB procedure, or the total anesthetic time, both of which were not significantly different between the patient groups receiving the three different doses of droperidol. The magnitude or duration of hypothermia after CPB did not differ between the three patient groups. The differences in half-lives are more likely due to the clinical condition of the patients, such that the patients who received the higher doses of droperidol were also judged clinically to be less ill and thus eliminated droperidol more efficiently. This hypothesis, however, could not be supported due to the small number of patients studied. The results obtained in this study indicate that droperidol elimination is significantly prolonged after high-dose administration to elderly patients undergoing hypothermic CPB procedures during cardiac surgery.
Topics: Adjuvants, Anesthesia; Adult; Aged; Cardiopulmonary Bypass; Droperidol; Female; Half-Life; Humans; Male; Metabolic Clearance Rate; Middle Aged
PubMed: 9549647
DOI: 10.1002/j.1552-4604.1998.tb04405.x -
Gastrointestinal Endoscopy Oct 2003Performance of sphincter of Oddi manometry at ERCP is technically demanding and requires that the patient be well sedated. Droperidol is frequently administered when...
BACKGROUND
Performance of sphincter of Oddi manometry at ERCP is technically demanding and requires that the patient be well sedated. Droperidol is frequently administered when adequate sedation cannot be achieved with a benzodiazepine and meperidine. This study examined the effects of droperidol on the biliary and pancreatic sphincters.
METHODS
A total of 31 patients were prospectively evaluated by sphincter of Oddi manometry in the conventional retrograde fashion. Manometry was initially performed with intravenous administration of diazepam alone, diazepam plus meperidine or midazolam plus meperidine. Manometry was then repeated 5 minutes after droperidol was administered.
RESULTS
The basal pressure of the biliary sphincter and of the pancreatic sphincter were not significantly altered by droperidol. Concordance (normal vs. abnormal) between the basal sphincter pressure before and after droperidol was seen in 30 patients (97%). Droperidol also did not lead to a difference in phasic wave amplitude, duration, or frequency. Thirteen manometry tracings (42%) were judged as being qualitatively better after droperidol, whereas two (6.5%; = p 0.001) were qualitatively better before droperidol administration.
CONCLUSIONS
Droperidol does not significantly affect sphincter of Oddi manometric parameters. It appears that it can be added to the armamentarium of agents needed for performance of sphincter of Oddi manometry. However, further study is needed to determine whether recent safety concerns with droperidol use are valid.
Topics: Adjuvants, Anesthesia; Conscious Sedation; Droperidol; Female; Gastrointestinal Motility; Humans; Male; Manometry; Prospective Studies; Sphincter of Oddi
PubMed: 14520278
DOI: 10.1067/s0016-5107(03)01541-4 -
Annals of Emergency Medicine Jan 2016
Topics: Conscious Sedation; Dangerous Behavior; Droperidol; Emergency Service, Hospital; Female; Humans; Hypnotics and Sedatives; Male
PubMed: 26707529
DOI: 10.1016/j.annemergmed.2015.09.029 -
Masui. the Japanese Journal of... Aug 2005Continuous epidural administration of droperidol at 2.5 mg x day(-1) or less was performed in 837 patients after surgery. In 4 of these patients, an extrapyramidal... (Review)
Review
Continuous epidural administration of droperidol at 2.5 mg x day(-1) or less was performed in 837 patients after surgery. In 4 of these patients, an extrapyramidal reaction occurred. Patient 1 was a 10-year-old girl who developed the symptom 29 hours after the start of administration, with a total dose of 3.0 mg. Patient 2 was a 16-year-old girl in whom the symptom occurred 24 hours after the start, with a total of 5.3 mg. Patient 3 was a 22-year-old female with the symptom occurring 26 hours after the start, with a total of 5.2 mg. Patient 4 was a 74-year-old female in whom the symptom occurred 24 hours after the start, with a total of 1.3 mg. With respect to the age distribution, the total of 837 patients consisted of 16 patients aged 10 to 19 years, 85 patients aged 20 to 29 years, 91 patients aged 30 to 39 years, 90 patients aged 40 to 49 years, 77 patients aged 50 to 59 years, 148 patients aged 60 to 69 years, 240 patients aged 70 to 79 years, 97 patients aged 80 to 89 years, and 9 patients aged 90 to 99 years. Extrapyramidal reactions related to epidural administration may readily develop at younger ages.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Antiemetics; Basal Ganglia Diseases; Child; Dose-Response Relationship, Drug; Droperidol; Female; Humans; Injections, Epidural; Postoperative Nausea and Vomiting
PubMed: 16104540
DOI: No ID Found -
Acta Anaesthesiologica Scandinavica Nov 2000Droperidol and 5-HT3-receptor antagonists are among the most potent antiemetics to prevent postoperative nausea and vomiting (PONV). Combinations of these drugs have... (Clinical Trial)
Clinical Trial Meta-Analysis Randomized Controlled Trial
BACKGROUND
Droperidol and 5-HT3-receptor antagonists are among the most potent antiemetics to prevent postoperative nausea and vomiting (PONV). Combinations of these drugs have been used to increase the efficacy of antiemetic treatment. However, so far the quantitative effect of this combination has not been evaluated systematically.
METHODS
Results from randomised controlled trials investigating the efficacy of 5-HT3-receptor antagonists or droperidol alone versus the combination of both drugs to prevent PONV were included in a meta-analysis. Studies were systematically searched using Medline, EMBASE, the Cochrane-Library, and by manually screening the reference lists of matching review articles and current issues of locally available peer-reviewed anaesthesia journals. Seven papers with data on granisetron published by Fujii and co-workers were not considered. The main end point in each study was defined as occurrence of nausea, retching, or vomiting within 6 h ("early PONV") and within 48 h ("late PONV") after surgery. The relative risks (RR) and the numbers needed to treat (NNT) of the pooled data with their corresponding 95% confidence intervals (given in parentheses) were calculated using a random effects model.
RESULTS
Eight studies with 881 patients (adults: n=801; children (mean age: 8 yr): n=80) were included in the analysis. Droperidol was applied to 340 patients, 5-HT3-receptor antagonists to 198, and 343 were treated with a combination of both drugs. Seven out of these eight studies reported increased antiemetic efficacy of the combination group compared with the single drugs (droperidol and 5-HT3-receptor antagonists respectively). However, in none of the trials did this difference reach statistical significance. When a meta-analytic analysis based on these results was performed the combination of droperidol with a 5-HT3-receptor antagonist was not associated with a significantly increased antiemetic efficacy. In 12 to 13 patients a 5-HT3-receptor antagonist has to be added to droperidol prophylaxis to prevent one additional patient from PONV who would have had suffered from PONV when treated with droperidol alone (RR "early PONV": 1.52 (0.95-2.44); RR "late PONV": 1.24 (0.89-1.74)). Similar results were obtained when the antiemetic effect of adding droperidol to a prophylaxis with 5-HT3-receptor antagonists was analysed. In this case 10 to 12 patients have to be treated with the 5-HT3-droperidol combination instead of with a 5-HT3-receptor antagonist alone to prevent one additional patient from PONV (RR "early PONV": 1.55 (0.68-3.52); RR "late PONV": 1.29 (0.77-2.17)). There were no reports of an increased incidence of adverse effects.
CONCLUSION
The data on the combination of droperidol with 5-HT3-receptor antagonists suggest that there is a trend towards increased efficacy of the combination therapy compared to the single drugs. However, so far there are insufficient data to recommend this combination treatment for prophylaxis.
Topics: Antiemetics; Droperidol; Drug Therapy, Combination; Humans; Postoperative Nausea and Vomiting; Serotonin Antagonists
PubMed: 11065206
DOI: 10.1034/j.1399-6576.2000.441011.x -
Revista Espanola de Anestesiologia Y... May 2003
Topics: Adjuvants, Anesthesia; Antiemetics; Death, Sudden, Cardiac; Dose-Response Relationship, Drug; Droperidol; Humans; Intraoperative Complications; Long QT Syndrome; Postoperative Complications
PubMed: 12833794
DOI: No ID Found -
Emergency Medicine Australasia : EMA Oct 2022Headache is a common presenting complaint to the ED. Using time from the first provider to discharge as a surrogate for effectiveness, we aimed to determine if... (Observational Study)
Observational Study
OBJECTIVE
Headache is a common presenting complaint to the ED. Using time from the first provider to discharge as a surrogate for effectiveness, we aimed to determine if intranasal (IN) droperidol is as beneficial as usual treatment for acute headache in the ED.
METHODS
There were 1213 consecutive presentations of adults with acute headache over a 42-month period. Electronic records for each event were interrogated, 406 events met pre-determined exclusion criteria. Of the remaining 805 eligible patient events, 139 received IN droperidol, whereas 666 were given usual therapy.
RESULTS
There was a 20 min reduction of mean and median ED length of stay (LOS) for the group that got treated with IN droperidol.
CONCLUSIONS
IN droperidol reduced LOS in the ED. There are potential cost savings of this effective treatment via this novel route. A prospective multi-centre study of the use of IN droperidol for the treatment of acute headache in the ED is recommended.
Topics: Adult; Droperidol; Emergency Service, Hospital; Headache; Humans; Prospective Studies; Retrospective Studies
PubMed: 35568501
DOI: 10.1111/1742-6723.14006 -
The Journal of Nervous and Mental... Apr 1977Forty-one acutely agitated patients received an i.v. injection of 4 ml of a double blind solution containing either 10 mg of droperidol or placebo. The need for further... (Clinical Trial)
Clinical Trial
Forty-one acutely agitated patients received an i.v. injection of 4 ml of a double blind solution containing either 10 mg of droperidol or placebo. The need for further medication (5 mg of haloperidol after 3 minutes or individually adapted psychotropics after 30 minutes) was used as a parameter for the evaluation of the results. Three minutes after the injection, haloperidol was needed by only six out of 19 patients of the droperidol group, but by 19 patients of the control group. Thirty minutes after the first injection, further medication was needed by only four droperidol patients and 10 placebo patients. No side effects could be attributed to the double blind medication.
Topics: Acute Disease; Adolescent; Adult; Aged; Bipolar Disorder; Clinical Trials as Topic; Droperidol; Drug Evaluation; Drug Therapy, Combination; Female; Haloperidol; Humans; Male; Middle Aged; Schizophrenia
PubMed: 321727
DOI: 10.1097/00005053-197704000-00008 -
Gastrointestinal Endoscopy Oct 2003
Topics: Adjuvants, Anesthesia; Conscious Sedation; Droperidol; Gastrointestinal Motility; Humans; Manometry; Sphincter of Oddi
PubMed: 14520291
DOI: 10.1067/s0016-5107(03)01972-2 -
Academic Emergency Medicine : Official... Sep 2001To compare the efficacy of droperidol with that of prochlorperazine for the treatment of benign headaches in emergency department (ED) patients. (Clinical Trial)
Clinical Trial Randomized Controlled Trial
OBJECTIVE
To compare the efficacy of droperidol with that of prochlorperazine for the treatment of benign headaches in emergency department (ED) patients.
METHODS
Prospective, randomized clinical trial in an urban ED. Patients were given either droperidol, 5 mg intramuscular (IM) or 2.5 mg intravenous (IV), or prochlorperazine, 10 mg IM or 10 mg IV. Measurements included side effects and the patient's pain perception as measured on a 100-mm visual analog scale (VAS) at baseline, 30, and 60 minutes after the medication was given. Data were analyzed using chi-square, two-tailed t-tests, and two-way analysis of variance (ANOVA) when appropriate.
RESULTS
During an eight-month period, 168 patients were enrolled. Eighty-two (48.8%) of the patients received droperidol; 86 (51.2%) received prochlorperazine. In the droperidol group, 49 (59.6%) received IM administration and 33 (40.4%) IV. In the prochlorperazine group, 57 (66.3%) received IM administration and 29 (33.7%) IV. Sixty minutes after the medication, the mean decrease in the VAS scores was 81.4% for droperidol and 66.9% for prochlorperazine (p = 0.001). At 30 minutes, 60.9% of the patients receiving droperidol and 44.2% of the patients receiving prochlorperazine had obtained at least a 50% reduction in their VAS scores (p = 0.09). At 60 minutes, 90.2% of the patients receiving droperidol and 68.6% of the patients receiving prochlorperazine had at least a 50% reduction in their VAS scores (p = 0.017). No difference between IM dosing and IV dosing was detected. Side effects, including dystonia, akathisia, and decreased level of consciousness, were seen in 15.2% of the patients receiving droperidol and 9.61% of the patients receiving prochlorperazine. No significant or persisting morbidity was detected.
CONCLUSIONS
Droperidol was more effective than prochlorperazine in relieving pain associated with benign headaches.
Topics: Adult; Analysis of Variance; Dopamine Antagonists; Droperidol; Emergency Service, Hospital; Female; Headache; Humans; Injections, Intramuscular; Injections, Intravenous; Male; Middle Aged; Pain Measurement; Prochlorperazine; Treatment Outcome
PubMed: 11535479
DOI: 10.1111/j.1553-2712.2001.tb01147.x