COMPARISON OF DIFFERENT METHODS OF ADMINISTERING DROPERIDOL IN PATIENT-CONTROLLED ANALGESIA IN THE PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING

We performed a double-blind, placebo-controlled study to evaluate the different methods of administering droperidol in patients using patien t-controlled analgesia (PCA) with morphine. Eighty patients undergoing major orthopedic procedures received temazepam 0.2 mg/kg orally follo wed by induction of general anesthesia with propofol 2.5 mg/kg, fentan yl 2 mu g/kg, and vecuronium 0.1 mg/kg. Anesthesia was maintained with nitrous oxide, oxygen, and enflurane. At the end of surgery, all pati ents received PCA with morphine (0.5 mg/mL, bolus dose 1 mg, and locko ut interval 5 min. Before commencement of PCA, patients were randomize d to receive droperidol 1.25 mg immediately and, in addition, droperid ol 0.16 mg with each PCA dose (Group 1), droperidol 1.25 mg immediatel y (Group 2), droperidol 0.16 mg with each PCA dose (Group 3), and no d roperidol (Group 4). Incidence of nausea and vomiting, request for res cue antiemetics, sedation score, and side effects were recorded every 4 h. Droperidol significantly reduced the incidence of postoperative n ausea and vomiting (PONV) (P < 0.01) and request for rescue antiemetic (P < 0.01) compared to placebo. However, there was no difference in t he incidence of PONV between droperidol given either as a single dose at the end of surgery (Group 2) or mixed in morphine PCA (Group 3). Th e addition of droperidol in PCA after an initial dose (Group 1) should be avoided, as it resulted in more sedation and no further reduction in the incidence of PONV compared to Groups 2 and 3.