Droperidol-supplemented anaesthesia decreases post-operative nausea and vomiting but impairs post-operative mood and well-being

Post-operative nausea and vomiting is distressing for patients and can caus e dissatisfaction and impaired well-being in the post-operative period. Thi s study examined the question whether the reduced incidence of post-operati ve nausea and vomiting inevitably translates into improved clinical status and well-being. In this context high doses of droperidol were investigated. On the one hand, droperidol is known to be a powerful anti-emetic, but on the other hand there is concern about psychological effects, both in the pr e- and the post-operative period. In this prospective randomized double-bli nded study, droperidol (5-7.5 mg) was compared with midazolam (5-7.5 mg) us ed to supplement fentanyl-N2O based anaesthesia, with respect to post-opera tive mood and well-being using a psychological questionnaire (Bf-S-test). F urthermore, the incidence of post-operative nausea and vomiting was recorde d. Out of 160 patients undergoing thyroidectomy and laparoscopic cholecyste ctomy, data from 150 patients were analysed. The administration of droperid ol significantly lowered the incidence of post-operative nausea and vomitin g from 77.8% to 55.1% compared with midazolam (P=0.0059; chi(2)-test). Alth ough post-operative nausea and vomiting is an independent risk factor for p ost-operative discomfort and bad mood, patients receiving droperidol showed impaired well-being 6 h after surgery. Well-being scores returned to pre-o perative base-line values and did not differ between the two groups 24 and 48 h post-operatively. The reduced incidence of post-operative nausea and v omiting achieved with high dose droperidol does not equate with increased p ost-operative well-being. It is an important point at issue to decide wheth er smaller doses of droperidol that are commonly used for anti-emetic thera py are free of these side effects.