Tj. Gan et al., COMPARISON OF DIFFERENT METHODS OF ADMINISTERING DROPERIDOL IN PATIENT-CONTROLLED ANALGESIA IN THE PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING, Anesthesia and analgesia, 80(1), 1995, pp. 81-85
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.