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Intravenous Droperidol

A Review of its Use in the Management of Postoperative Nausea and Vomiting

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Summary

Abstract

Droperidol (Dehydrobenzperidol®, Dehidrobenzoperidol®, Dridol®, Droleptan®, Inapsine®) is a dopamine D2 receptor antagonist that has been widely used in adults and children for the prevention and treatment of postoperative nausea and vomiting (PONV) over several decades and, more recently, for the prevention of opioid-induced PONV during patient-controlled analgesia (PCA) in adults. In well controlled clinical trials of patients undergoing surgery, the efficacy of single-dose intravenous (IV) droperidol in preventing PONV was similar to that of ondansetron and dexamethasone. Droperidol significantly reduced opioid-induced PONV in adults during PCA and had a morphine-sparing effect. Droperidol is generally well tolerated and the incidence of adverse effects is similar to that observed with placebo and the serotonin 5-HT3 receptor antagonists (setrons). Guidelines recommend that, in adults, droperidol monotherapy be considered for those at moderate risk of PONV, and droperidol in combination with a setron and/or dexamethasone be considered for patients at moderate or high risk of PONV. In children with moderate or high risk of PONV, droperidol is recommended for first-line use in some countries, and second-line use in others.

Pharmacological Properties

Droperidol is a butyrophenone derivative and dopamine antagonist with high and preferential affinity for D2 receptors and a slightly lower affinity for α1A adrenergic receptors. Droperidol antagonises the effects of apomorphine, and its antiemetic effects in the prevention and treatment of PONV have been demonstrated in patients undergoing anaesthesia for a variety of surgical procedures. No overall respiratory depression has been demonstrated with droperidol, but its coadministration with known respiratory depressants requires monitoring due to individual variation among recipients. The drug has been associated with a dose-dependent prolongation of the frequency-corrected QT interval.

The pharmacokinetics of droperidol are linear for the dose range used to manage PONV and values are similar in anaesthetised patients and healthy volunteers. Droperidol is rapidly distributed into the brain, is extensively metabolised by the liver, and excreted primarily in the urine. The terminal elimination half-life of droperidol is approximately 2 hours. Coadministration of droperidol with halothane or isoflurane does not affect its pharmacokinetics. IV droperidol administered in children results in a lower clearance rate and volume of distribution than in adults, but a similar terminal elimination half-life.

Therapeutic Efficacy

IV droperidol (0.625–2.5mg in adults; 0.02–0.075 mg/kg in children) has demonstrated efficacy in the prevention and treatment of PONV in adults and postoperative vomiting (POV) in children. Overall, in large, well designed clinical trials in the prevention of PONV, the efficacy of single-dose droperidol in adults and children appeared to be similar to that of ondansetron, and similar to or lower than that of granisetron. In adults and children, combination therapy with droperidol plus a setron generally enhanced efficacy compared with monotherapy.

Overall, in the comparative trials of conventional antiemetics reviewed here, droperidol demonstrated similar efficacy in the prevention of PONV to dexamethasone, dimenhydrinate and promethazine, and generally superior efficacy to metoclopramide. A large randomised factorial trial found that droperidol, ondansetron or dexamethasone each reduced the relative risk of PONV by about one-quarter.

In several well controlled trials that investigated the prevention of opioidinduced PONV in patients using PCA after surgery, droperidol was more effective and associated with a lower need for rescue antiemetics than placebo or no prophylaxis. Efficacy against opioid-induced PONV appeared similar with droperidol or ondansetron in two large studies. A morphine-sparing effect was associated with droperidol use in PCA following surgery; morphine use and pain intensity were significantly lower in patients receiving droperidol than in those receiving placebo.

A cost-effectiveness study using a model based on clinical data demonstrated that droperidol 1.25mg was dominant to droperidol 0.625mg, ondansetron 4mg and placebo with regard to gaining one more PONV-free patient. In a further study, the extra cost associated with droperidol plus ondansetron compared with droperidol plus dexamethasone was reasonable given the improved efficacy.

Tolerability

IV droperidol is generally well tolerated in adults and children. In numerous clinical trials of patients undergoing various surgical procedures, the overall incidence of adverse events with single-dose droperidol was similar to that reported with placebo.

The most common adverse event associated with droperidol is sedation, which is dose dependent and more likely to occur in the early postoperative period (i.e. up to 6 hours). In a large well designed trial, the most common adverse events associated with droperidol were sedation, headache and dizziness. Overall, the incidence of adverse effects with droperidol is similar to that seen with setrons, but droperidol is more likely to cause sedation and less likely to cause headaches.

At droperidol dosages used for the prevention of PONV, extrapyramidal symptoms (e.g. dyskinesias) are very unlikely.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Kazemi-Kjellberg F, Henzi I, Tramer MR. Treatment of established postoperative nausea and vomiting: a quantitative systematic review. BMC Anesthesiology 2001; 1(1): 2

    Article  PubMed  Google Scholar 

  2. Watcha MF, White PF. Postoperative nausea and vomiting: its etiology, treatment and prevention. Anesthesiology 1992; 77: 162–84

    Article  PubMed  CAS  Google Scholar 

  3. Apfel CC, Laara E, Koivuranta M, et al. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology 1999 Sep; 91(3): 693–700

    Article  PubMed  CAS  Google Scholar 

  4. Ved SA, Waiden TL, Montana J, et al. Vomiting and recovery after outpatient tonsillectomy and adenoidectomy in children. Anesthesiology 1996; 85(1): 4–10

    Article  PubMed  CAS  Google Scholar 

  5. Kovac AL. Prevention and treatment of postoperative nausea and vomiting. Drugs 2000 Feb; 59(2): 213–43

    Article  PubMed  CAS  Google Scholar 

  6. United States Food and Drug Administration. FDA strengthens warnings for droperidol [online]. Available from URL: http://www.fda.gov [Accessed 2006 Jul 5]

  7. Mullins M, Van Zwieten K, Blunt JR. Unexpected cardiovascular deaths are rare with therapeutic doses of droperidol. Am J Emerg Med 2004 Jan; 22(1): 27–8

    Article  PubMed  Google Scholar 

  8. White PF, Song D, Abrao J, et al. Effect of low-dose droperidol on the QT interval during and after general anesthesia: a placebo-controlled study. Anesthesiology 2005 Jun; 102(6): 1101–5

    Article  PubMed  CAS  Google Scholar 

  9. Scuderi PE. You (still) can’t disprove the existence of dragons. Anesthesiology 2005 Jun; 102(6): 1081–2

    Article  PubMed  Google Scholar 

  10. Habib AS, Gan TJ. Food and drug administration black box warning on the perioperative use of droperidol: a review of the cases. Anesth Analg 2003 May; 96(5): 1377–9

    Article  PubMed  Google Scholar 

  11. Gan TJ, White PF, Scuderi PE, et al. FDA “black box” warning regarding use of droperidol for postoperative nausea and vomiting: is it justified? [letter]. Anesthesiology 2002 Jul; 97(1): 287

    Article  PubMed  Google Scholar 

  12. Dershwitz M. Droperidol: should the black box be light gray? J Clin Anesth 2002 Dec; 14(8): 598–603

    Article  PubMed  CAS  Google Scholar 

  13. Scuderi PE. Droperidol: many questions, few answers. Anesthesiology 2003 Feb; 98(2): 289–90

    Article  PubMed  Google Scholar 

  14. Bailey P, White PF. Droperidol editorial: making a mountain out of a mole hill! [letter]. Anesthesiology 2003 Sep; 99(3): 760–1; author reply 761

    Article  PubMed  Google Scholar 

  15. OTL Pharma. Dehydrobenzperidol: summary of product characteristics. Belgium: ProStrakan, 2004

    Google Scholar 

  16. OTL Pharma. Droperidol solution for IV and IM injection. Core Scientific Brochure. ProStraken, 2003

  17. Janssen PA, Niemegeers CJ, Schellekens KH, et al. The pharmacology of dehydrobenzperidol, a new potent and short acting neuroleptic agent chemically related to haloperidol. Arzneimittelforschung 1963 Mar; 13: 205–11

    PubMed  CAS  Google Scholar 

  18. Rowbotham DJ. Current management of postoperative nausea and vomiting. Br J Anaesth 1992; 69 (7 Suppl. 1): 46S–59S

    Article  PubMed  CAS  Google Scholar 

  19. Stead SW, Beatie CD, Keyes MA, et al. Effects of droperidol dosage on postoperative emetic symptoms following pediatric strabismus surgery. J Clin Anesth 2004 Feb; 16(1): 34–9

    Article  PubMed  CAS  Google Scholar 

  20. Williams OA, Clarke FL, Harris RW, et al. Addition of droperidol to patient-controlled analgesia: effect on nausea and vomiting. Anaesthesia 1993 Oct; 48(10): 881–4

    Article  PubMed  CAS  Google Scholar 

  21. Prokocimer P, Delavault E, Rey F, et al. Effects of droperidol on respiratory drive in humans. Anesthesiology 1983 Aug; 59(2): 113–6

    Article  PubMed  CAS  Google Scholar 

  22. Harper MH, Hickey RF, Cromwell TH, et al. The magnitude and duration of respiratory depression produced by fentanyl and fentanyl plus droperidol in man. J Pharmacol Exp Ther 1976 Nov; 199(2): 464–8

    PubMed  CAS  Google Scholar 

  23. Becker LD, Paulson BA, Miller RD, et al. Biphasic respiratory depression after fentanyldroperidol or fentanyl alone used to supplement nitrous oxide anesthesia. Anesthesiology 1976 Apr; 44(4): 291–6

    Article  PubMed  CAS  Google Scholar 

  24. Lischke V, Behne M, Doelken P, et al. Droperidol causes a dose-dependent prolongation of the QT interval. Anesth Analg 1994 Nov; 79(5): 983–6

    Article  PubMed  CAS  Google Scholar 

  25. Marty J, Nitenberg A, Blanchet F, et al. Effects of droperidol on left ventricular performance in humans. Anesthesiology 1982 Jul; 57(1): 22–5

    Article  PubMed  CAS  Google Scholar 

  26. Stanley TH, Bennett GM, Loeser EA, et al. Cardiovascular effects of diazepam and droperidol during morphine anesthesia. Anesthesiology 1976 Mar; 44(3): 255–8

    Article  PubMed  CAS  Google Scholar 

  27. Desai M, Pinto A, Adigun A, et al. Pharmacokinetics and QT interval pharmacodynamics of single intravenous doses of droperidol [online]. Available from URL: http://www.cfsan.fda.gov [Accessed 2006 Aug 15]

  28. Balagny D, Gauzit R, Marty J, et al. Effects of droperidol on sympathetic activity and baroreflex control of heart rate in humans. Anesthesiology 1987 Oct; 67(4): 473–6

    Article  PubMed  CAS  Google Scholar 

  29. Bissonnette B, Swan H, Ravussin P, et al. Neuroleptanesthesia: current status. Can J Anesth 1999; 46(2): 154–68

    Article  PubMed  CAS  Google Scholar 

  30. Tammisto T, Takki S, Nikki P, et al. Effect of operative stress on plasma catecholamine levels during neuroleptanalgesia. Anaesthesist 1973 Apr; 22(4): 158–61

    PubMed  CAS  Google Scholar 

  31. Charbit B, Albaladejo P, Funck-Brentano C, et al. Prolongation of QTc interval after postoperative nausea and vomiting treatment by droperidol or ondansetron. Anesthesiology 2005 Jun; 102(6): 1094–100

    Article  PubMed  Google Scholar 

  32. Chan MTV, Choi KC, Gin T, et al. The additive interactions between ondansetron and droperidol for preventing postoperative nausea and vomiting. Anesth Analg 2006 Nov; 103(5): 1155–62

    Article  PubMed  CAS  Google Scholar 

  33. Cressman WA, Plostnieks J, Johnson PC. Absorption, metabolism and excretion of droperidol by human subjects following intramuscular and intravenous administration. Anesthesiology 1973 Apr; 38(4): 363–9

    Article  PubMed  CAS  Google Scholar 

  34. Fischler M, Bonnet F, Trang H, et al. The pharmacokinetics of droperidol in anesthetized patients. Anesthesiology 1986 Apr; 64(4): 486–9

    Article  PubMed  CAS  Google Scholar 

  35. Lehmann KA, Van Peer A, Ikonomakis M, et al. Pharmacokinetics of droperidol in surgical patients under different conditions of anaesthesia. Br J Anaesth 1988 Sep; 61(3): 297–301

    Article  PubMed  CAS  Google Scholar 

  36. Grunwald Z, Torjman M, Schieren H, et al. The pharmacokinetics of droperidol in anesthetized children. Anesth Analg 1993 Jun; 76(6): 1238–42

    PubMed  CAS  Google Scholar 

  37. Gan TJ, Meyer T, Apfel CC, et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 2003 Jul; 97(1): 62–71

    Article  PubMed  Google Scholar 

  38. Nesek-Adam V, Grizelj-Stojcic E, Mrsic V, et al. Prophylactic antiemetics for laparoscopic cholecystectomy: droperidol, metoclopramide, and droperidol plus metoclopramide. J Laparoendosc Adv Surg Tech A 2004 Aug; 14(4): 212–8

    PubMed  Google Scholar 

  39. Paech MJ, Pavy TJG, Evans SF. Single-dose prophylaxis for postoperative nausea and vomiting after major abdominal surgery: ondansetron versus droperidol. Anaesth Intensive Care 1995 Oct; 23: 548–54

    PubMed  CAS  Google Scholar 

  40. Desilva PH, Darvish AH, McDonald SM, et al. The efficacy of prophylactic ondansetron, droperidol, perphenazine, and metoclopramide in the prevention of nausea and vomiting after major gynecologic surgery. Anesth Analg 1995 Jul; 81(1): 139–43

    PubMed  CAS  Google Scholar 

  41. Koivuranta M, Laara E, Ranta P, et al. Comparison of ondansetron and droperidol in the prevention of postoperative nausea and vomiting after laparoscopic surgery in women: a randomised, double-blind, placebo-controlled trial. Acta Anaesthesiol Scand 1997 Nov; 41: 1273–9

    Article  PubMed  CAS  Google Scholar 

  42. Reihner E, Grunditz R, Giesecke K, et al. Postoperative nausea and vomiting after breast surgery: efficacy of prophylactic ondansetron and droperidol in a randomized placebo-controlled study. Eur J Anaesthesiol 2000 Mar; 17: 197–203

    PubMed  CAS  Google Scholar 

  43. Alkaissi A, Gunnarsson H, Johnsson V, et al. Disturbing postoperative symptoms are not reduced by prophylactic antiemetic treatment in patients at high risk of post-operative nausea and vomiting. Acta Anaesthesiol Scand 2004 Jul; 48(6): 761–71

    Article  PubMed  CAS  Google Scholar 

  44. Fujii Y, Saitoh Y, Tanaka H, et al. Prophylactic antiemetic therapy with granisetron-droperidol combination in patients undergoing laparoscopic cholecystectomy. Can J Anaesth 1998 Jun; 45(6): 541–4

    Article  PubMed  CAS  Google Scholar 

  45. Fujii Y, Saitoh Y, Tanaka H, et al. Prevention of post-operative nausea and vomiting with combined granisetron and droperidol in women undergoing thyroidectomy. Eur J Anaesthesiol 1999 Oct; 16(10): 688–91

    PubMed  CAS  Google Scholar 

  46. Fujii Y, Toyooka H, Tanaka H. Granisetron-droperidol combination for the prevention of postoperative nausea and vomiting in female patients undergoing breast surgery. Br J Anaesth 1998 Sep; 81: 387–9

    Article  PubMed  CAS  Google Scholar 

  47. Fujii Y, Toyooka H, Tanaka H. Prophylactic anti-emetic therapy with granisetron, droperidol and metoclopramide in female patients undergoing middle ear surgery. Anaesthesia 1998 Dec; 53(12): 1165–8

    Article  PubMed  CAS  Google Scholar 

  48. Fujii Y, Toyooka H, Tanaka H. Prevention of postoperative nausea and vomiting with a combination of granisetron and droperidol. Anesth Analg 1998 Mar; 86: 613–6

    PubMed  CAS  Google Scholar 

  49. Purhonen S, Kauko M, Koski EMJ, et al. Comparison of tropisetron, droperidol, and saline in the prevention of postoperative nausea and vomiting after gynecologic surgery. Anesth Analg 1997 Mar; 84: 662–7

    PubMed  CAS  Google Scholar 

  50. Fujii Y, Tanaka H, Toyooka H. The effects of dexamethasone on antiemetics in female patients undergoing gynecologic surgery. Anesth Analg 1997 Oct; 85(4): 913–7

    PubMed  CAS  Google Scholar 

  51. Tzeng JI, Tswei TS, Tang CS, et al. Dexamethasone alone does not prevent postoperative nausea and vomiting in women undergoing dilatation and curettage: a comparison with droperidol and saline. Acta Anaesthesiol Sin 2000 Sep; 38(3): 137–42

    PubMed  CAS  Google Scholar 

  52. Wang JJ, Ho ST, Lee SC, et al. The prophylactic effect of dexamethasone on postoperative nausea and vomiting in women undergoing thyroidectomy: a comparison of droperidol with saline. Anesth Analg 1999 Jul; 89(1): 200–3

    PubMed  CAS  Google Scholar 

  53. Culebras X, Corpataux JB, Gaggero G, et al. The antiemetic efficacy of droperidol added to morphine patient-controlled analgesia: a randomized, controlled, multicenter dose-finding study. Anesth Analg 2003; 97(3): 816–21

    Article  PubMed  CAS  Google Scholar 

  54. Lo Y, Chia YY, Liu K, et al. Morphine sparing with droperidol in patient-controlled analgesia. J Clin Anesth 2005 Jun; 17(4): 271–5

    Article  PubMed  CAS  Google Scholar 

  55. Jokela R, Koivuranta M. Tropisetron or droperidol in the prevention of postoperative nausea and vomiting: a comparative, randomised, double-blind study in women undergoing laparoscopic cholecystectomy. Acta Anaesthesiol Scand 1999 Jul; 43: 645–50

    Article  PubMed  CAS  Google Scholar 

  56. McKenzie R, Uy NT, Riley TJ, et al. Droperidol/ondansetron combination controls nausea and vomiting after tubal banding. Anesth Analg 1996 Dec; 83(6): 1218–22

    PubMed  CAS  Google Scholar 

  57. Sniadach MS, Alberts MS. A comparison of the prophylactic antiemetic effect of ondansetron and droperidol on patients undergoing gynecologic laparoscopy. Anesth Analg 1997 Oct; 85: 797–800

    PubMed  CAS  Google Scholar 

  58. Bugedo G, Gonzalez J, Asenjo C, et al. Ondansetron and droperidol in the prevention of postoperative nausea and vomiting. Br J Anaesth 1999 Nov; 83: 813–4

    Article  PubMed  CAS  Google Scholar 

  59. Fortney JT, Gan TJ, Graczyk S, et al. A comparison of the efficacy, safety, and patient satisfaction of ondansetron versus droperidol as antiemetics for elective outpatient surgical procedures. S3A-409 and S3A-410 Study Groups. Anesth Analg 1998 Apr; 86(4): 731–8

    CAS  Google Scholar 

  60. Janknegt R, Pinckaers JW, Rohof MH, et al. Double-blind comparative study of droperidol, granisetron and granisetron plus dexamethasone as prophylactic anti-emetic therapy in patients undergoing abdominal, gynaecological, breast or otolaryngological surgery. Anaesthesia 1999 Nov; 54(11): 1059–68

    Article  PubMed  CAS  Google Scholar 

  61. Kaufmann MA, Rosow C, Schnieper P, et al. Prophylactic antiemetic therapy with patient-controlled analgesia: a double-blind, placebo-controlled comparison of droperidol, metoclopramide, and tropisetron. Anesth Analg 1994 May; 78: 988–94

    Article  PubMed  CAS  Google Scholar 

  62. Steinbrook RA, Gosnell JL, Freiberger D. Prophylactic antiemetics for laparoscopic cholecystectomy: a comparison of perphenazine, droperidol plus ondansetron, and droperidol plus metoclopramide. J Clin Anesth 1998 Sep; 10: 494–8

    Article  PubMed  CAS  Google Scholar 

  63. Rothenberg DM, McCarthy RJ, Peng CC, et al. Nausea and vomiting after dexamethasone versus droperidol following outpatient laparoscopy with a propofol-based general anesthetic. Acta Anaesthesiol Scand 1998 Jul; 42(6): 637–42

    Article  PubMed  CAS  Google Scholar 

  64. Fujii Y, Saitoh Y, Tanaka H, et al. Combination of granisetron and droperidol in the prevention of nausea and vomiting after middle ear surgery. J Clin Anesth 1999 Mar; 11: 108–12

    Article  PubMed  CAS  Google Scholar 

  65. Riley TJ, McKenzie R, Trantisira BR, et al. Droperidol-ondansetron combination versus droperidol alone for postoperative control of emesis after total abdominal hysterectomy. J Clin Anesth 1998 Feb; 10(1): 6–12

    Article  PubMed  CAS  Google Scholar 

  66. Eberhart LHJ, Morin AM, Hoerle S, et al. Droperidol and dolasetron alone or in combination for prevention of postoperative nausea and vomiting after vitrectomy. Ophthalmology 2004 Aug; 111(8): 1569–75

    Article  PubMed  Google Scholar 

  67. Eberhart LH, Seeling W, Hartschuh T, et al. Droperidol and dimenhydrinate alone or in combination for the prevention of post-operative nausea and vomiting after nasal surgery in male patients. Eur J Anaesthesiol 1999 Nov; 16(11): 790–5

    PubMed  CAS  Google Scholar 

  68. Hechler A, Neumann S, Jehmlich M, et al. A small dose of droperidol decreases postoperative nausea and vomiting in adults but cannot improve an already excellent patient satisfaction. Acta Anaesthesiol Scand 2001 Apr; 45: 501–6

    Article  PubMed  CAS  Google Scholar 

  69. Domino KB, Anderson EA, Polissar NL, et al. Comparative effect and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis. Anesth Analg 1999 Jun; 88: 1370–9

    PubMed  CAS  Google Scholar 

  70. Loewen PS, Marra CA, Zed PJ. 5-HT3 receptor antagonists vs traditional agents for the prophylaxis of postoperative nausea and vomiting. Can J Anaesth 2000 Oct; 47(10): 1008–18

    Article  PubMed  CAS  Google Scholar 

  71. Apfel CC, Korttila K, Abdalla M, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med 2004 Jun 10; 350(24): 2441–51

    Article  PubMed  CAS  Google Scholar 

  72. Habib AS, El-Moalem HE, Gan TJ. The efficacy of the 5-HT3 receptor antagonists combined with droperidol for PONV prophylaxis is similar to their combination with dexamethasone: a meta-analysis of randomized controlled trials. Can J Anaesth 2004 Apr; 51(4): 311–9

    Article  PubMed  Google Scholar 

  73. Eberhart LHJ, Morin AM, Bothner U, et al. Droperidol and 5-HT3-receptor antagonists, alone or in combination, for prophylaxis of postoperative nausea and vomiting: a meta-analysis of randomised controlled trials. Acta Anaesthesiol Scand 2000 Nov; 44: 1252–7

    Article  PubMed  CAS  Google Scholar 

  74. Henzi I, Walder B, Tramer MR. Metoclopramide in the prevention of postoperative nausea and vomiting: a quantitative systemic review of randomized, placebo-controlled studies. Br J Anaesth 1999; 83(5): 761–71

    Article  PubMed  CAS  Google Scholar 

  75. Fujii Y, Toyooka H, Tanaka H. A granisetron-droperidol combination prevents postoperative vomiting in children. Anesth Analg 1998 Oct; 87: 761–5

    PubMed  CAS  Google Scholar 

  76. Furst SR, Rodarte A. Prophylactic antiemetic treatment with ondansetron in children undergoing tonsillectomy. Anesthesiology 1994 Oct; 81(4): 799–803

    Article  PubMed  CAS  Google Scholar 

  77. Splinter WM, Rhine EJ, Roberts DW, et al. Ondansetron is a better prophylactic antiemetic than droperidol for tonsillectomy in children. Can J Anaesth 1995 Oct; 42(10): 848–51

    Article  PubMed  CAS  Google Scholar 

  78. Davis A, Krige S, Moyes D. A double-blind randomized prospective study comparing ondansetron with droperidol in the prevention of emesis following strabismus surgery. Anaesth Intens Care 1995; 23(4): 438–43

    CAS  Google Scholar 

  79. Klockgether-Radke A, Neumann S, Neumann P, et al. Ondansetron, droperidol and their combination for the prevention of post-operative vomiting in children. Eur J Anaesthesiol 1997 Jul; 14: 362–7

    Article  PubMed  CAS  Google Scholar 

  80. Scuderi PE, Weaver Jr RG, James RL, et al. A randomized, double-blind, placebo controlled comparison of droperidol, ondansetron, and metoclopramide for the prevention of vomiting following outpatient strabismus surgery in children. J Clin Anesth 1997 Nov; 9(7): 551–8

    Article  PubMed  CAS  Google Scholar 

  81. Shende D, Bharti N, Kathirvel S, et al. Combination of droperidol and ondansetron reduces PONV after pediatric strabismus surgery more than single drug therapy. Acta Anaesthesiol Scand 2001 Jul; 45: 756–60

    Article  PubMed  CAS  Google Scholar 

  82. Blanc VF, Ruest P, Milot J, et al. Antiemetic prophylaxis with promethazine or droperidol in paediatric outpatient strabismus surgery. Can J Anaesth 1991 Jan; 38(1): 54–60

    Article  PubMed  CAS  Google Scholar 

  83. Lunn DV, Lauder GR, Williams AR, et al. Low-dose droperidol reduces postoperative vomiting in paediatric day surgery. Br J Anaesth 1995 May; 74: 509–11

    Article  PubMed  CAS  Google Scholar 

  84. Tramer M, Moore A, McQuay H. Prevention of vomiting after paediatric strabismus surgery: a systematic review using the numbers-needed-to-treat method. Br J Anaesth 1995 Nov; 75(5): 556–61

    Article  PubMed  CAS  Google Scholar 

  85. Millo J, Siddons M, Innes RJ, et al. Randomised double-blind comparison of ondansetron and droperidol to prevent postoperative nausea and vomiting associated with patient-controlled analgesia. Anaesthesia 2001 Jan; 56: 60–5

    Article  PubMed  CAS  Google Scholar 

  86. Grebenik CR, Allman C. Nausea and vomiting after cardiac surgery. Br J Anaesth 1996 Sep; 77(3): 356–9

    Article  PubMed  CAS  Google Scholar 

  87. Alexander R, Lovell AT, Seingry D, et al. Comparison of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia. Anaesthesia 1995 Dec; 50: 1086–8

    Article  PubMed  CAS  Google Scholar 

  88. Tramer MR, Walder B. Efficacy and adverse effects of prophylactic antiemetics during patient-controlled analgesia therapy: a quantitative systematic review. Anesth Analg 1999 Jun; 88(6): 1354–61

    PubMed  CAS  Google Scholar 

  89. Dabbous A, Khoury SJ, Chehab IR, et al. Ondansetron versus dehydrobenzoperidol and metoclopramide for management of ostoperative nausea in laparoscopic surgery patients. JSLS 2001; 5(2): 139–42

    PubMed  CAS  Google Scholar 

  90. Fujii Y, Tanaka H, Kawasaki T. Randomized clinical trial of granisetron, droperidol and metoclopramide for the treatment of nausea and vomiting after laparoscopic cholecystectomy. Br J Surg 2000 Mar; 87: 285–8

    Article  PubMed  CAS  Google Scholar 

  91. Fujii Y, Tanaka H, Somekawa Y. Granisetron, droperidol, and metoclopramide for the treatment of established postoperative nausea and vomiting in women undergoing gynecologic surgery. Am J Obstet Gynecol 2000 Jan; 182 (1 Pt 1): 13–6

    Article  PubMed  CAS  Google Scholar 

  92. Fujii Y, Tanaka H, Ito M. Treatment of vomiting after paediatric strabismus surgery with granisetron, droperidol, and metoclopramide. Ophthalmologica 2002; 216: 359–62

    Article  PubMed  CAS  Google Scholar 

  93. Helmy SA. Prophylactic anti-emetic efficacy of ondansetron in laparoscopic cholecystectomy under total intravenous anaesthesia: a randomised, double-blind comparison with droperidol, metoclopramide and placebo. Anaesthesia 1999 Mar; 54(3): 266–71

    Article  PubMed  CAS  Google Scholar 

  94. Henzi I, Sonderegger J, Tramer MR. Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting. Can J Anesth 2000 Jun; 47: 537–51

    Article  PubMed  CAS  Google Scholar 

  95. Leslie JB, Gan TJ. Meta-analysis of the safety of 5-HT3 antagonists with dexamethasone or droperidol for prevention of PONV. Ann Pharmacother 2006 May; 40(5): 856–72

    Article  PubMed  CAS  Google Scholar 

  96. Hill RP, Lubarsky DA, Phillips-Bute B, et al. Cost-effectiveness of prophylactic antiemetic therapy with ondansetron, droperidol, or placebo. Anesthesiology 2000 Apr; 92(4): 958–67

    Article  PubMed  CAS  Google Scholar 

  97. Pueyo FJ, Lopez-Olaondo L, Sanchez-Ledesma MJ, et al. Cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting. Br J Anaesth 2003 Oct; 91(4): 589–92

    Article  PubMed  CAS  Google Scholar 

  98. Sanchez-Ledesma MJ, Lopez-Olaondo L, Pueyo FJ, et al. A comparison of three antiemetic combinations for the prevention of postoperative nausea and vomiting. Anesth Analg 2002; 95: 1590–5

    Article  PubMed  CAS  Google Scholar 

  99. Cameron D, Gan TJ. Management of postoperative nausea and vomiting in ambulatory surgery. Anesth Clin North America 2003; 21: 347–65

    Article  CAS  Google Scholar 

  100. Habib AS, Gan TJ. Combination therapy for postoperative nausea and vomiting: a more effective prophylaxis? Ambulatory Surgery 2001; 9(2): 59–71

    Article  PubMed  Google Scholar 

  101. Kranke P, Apfel CC, Greim CA, et al. Methodological problems arising from ‘serial publishing’ on the effectiveness of granisetron in PONV [letter]. Br J Anaesth 1999; 82: 481–3

    Article  PubMed  CAS  Google Scholar 

  102. Apfel CC, Kranke P, Greim CA, et al. Non-systematic serial publishing is not appropriate and ethically questionable [letter]. Acta Anaesthesiol Scand 1999; 43: 486–7

    PubMed  CAS  Google Scholar 

  103. Kranke P, Apfel CC, Roewer N. Reported data of granisetron and postoperative nausea and vomiting by Fujii et al. are incredibly Nice! [letter]. Anesth Analg 2000; 90: 1004–7

    Article  PubMed  CAS  Google Scholar 

  104. Habib AS, Gan TJ. Evidence-based management of postoperative nausea and vomiting: a review. Can J Anaesth 2004; 51(4): 326–41

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Wolters Kluwer Health / Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland, 1311, New Zealand

    Kate McKeage, Dene Simpson & Antona J. Wagstaff

  2. Wolters Kluwer Health, Conshohocken, Pennsylvania, USA

    Kate McKeage, Dene Simpson & Antona J. Wagstaff

Authors
  1. Kate McKeage
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  2. Dene Simpson
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  3. Antona J. Wagstaff
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Corresponding author

Correspondence to Kate McKeage.

Additional information

Various sections of the manuscript reviewed by: A. Alkaissi, Department of Anesthesiology and Intensive Care, University Hospital in Linkoping, Linkoping, Sweden; G. Bugedo, Department of Intensive Care & Anesthesiology, Pontificial Catholic University of Chile, Santiago, Chile; L. Eberhart, Department of Anaesthesiology & Intensive Care, University Hospital Giessen-Marburg, Marburg, Germany; A.S. Habib, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA; W.S. Jellish, Department of Anesthesiology, Loyola University Medical Center, Maywood, Illinois, USA; P. Pan, Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

Data Selection

Sources: Medical literature published in any language since 1963 on ‘droperidol’, identified using MEDLINE and EMBASE, supplemented by AdisBase (a proprietary database of Adis International). Additional references were identified from the reference lists of published articles. Bibliographical information, including contributory unpublished data, was also requested from the company marketing the drug.

Search strategy: MEDLINE, EMBASE and AdisBase search terms were ‘droperidol’ and ‘postoperative nausea’ or ‘postoperative vomiting’ or ‘PONV’. Searches were last updated 7 November 2006.

Selection: Studies in patients undergoing surgery who received droperidol. Inclusion of studies was based mainly on the methods section of the trials. When available, large, well controlled trials with appropriate statistical methodology were preferred. Relevant pharmacodynamic and pharmacokinetic data are also included.

Index terms: Droperidol, dopamine receptor antagonist, emesis, pharmacodynamics, pharmacokinetics, postoperative nausea and vomiting, prevention, therapeutic use.

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McKeage, K., Simpson, D. & Wagstaff, A.J. Intravenous Droperidol. Drugs 66, 2123–2147 (2006). https://doi.org/10.2165/00003495-200666160-00009

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