A randomized double-blind placebo-controlled trial evaluating the cost-effectiveness of droperidol as a sedative premedication for EUS

Background: Droperidol is a neuroleptic agent with anti-emetic properties t hat produces mild sedation, reduced anxiety, and a state of mental detachme nt and indifference to one's surroundings. Routine premedication with drope ridol has been shown to improve sedation during esophagogastroduodenoscopy and endoscopic retrograde cholangiopancreatography. The purpose of this ran domized double-blind placebo-controlled study was to determine whether prem edication with droperidol improves sedation during routine upper endoscopic ultrasound (EUS) in a cost-effective manner. Methods: One hundred consecutive patients referred for EUS were randomly as signed to receive either 2.5 mg or 5 mg of droperidol or placebo before the procedure. After EUS, the physician, nurse, and recovered patient scored v arious parameters of procedural sedation. Results: In the group receiving 5 mg of droperidol there was significantly less gagging at intubation, less retching during the procedure, better pati ent cooperation, less need for physical restraint, and improved nurses' and physician's impression of sedation. Significantly less meperidine and less midazolam were required for sedation, making medication costs significantl y lower in the group receiving 5 mg droperidol. Conclusions: A 5 mg dose of droperidol given as premedication for routine u pper EUS improves sedation during the procedure while significantly decreas ing the overall cost of sedation.