A randomized, double-blind study of the use of droperidol for conscious sedation during therapeutic endoscopy in difficult to sedate patients

Background: Droperidol has been used in combination with narcotics and benz odiazepines to achieve conscious sedation. We performed a randomized, doubl e-blind, study of droperidol in patients at risk for difficult sedation sch eduled for therapeutic endoscopy. Methods: Patients with regular ethanol, narcotic, or benzodiazepine usage, suspected sphincter of Oddi dysfunction, or a history of difficult sedation were eligible for the study. Patients were randomized to receive either dr operidol or placebo along with midazolam and meperidine as preprocedure sed ation. Time to achieve sedation, interruptions due to undersedation, medica tion dosages, recovery time, and subjective assessments of sedation were re corded. Results: One hundred one patients were randomized. The droperidol group had significantly fewer procedure interruptions and observer ratings of diffic ulty with sedation and required significantly less midazolam (23%) and mepe ridine (16%) than the placebo group,There were no significant differences i n time to achieve sedation, incomplete procedures, procedure length, recove ry room time, or complications. There were significantly higher observer ra tings of the quality of sedation for patients who received droperidol, Conclusions: Droperidol is a useful adjunct to conscious sedation in patien ts who are difficult to sedate. Its use results in significantly fewer inte rruptions due to poor sedation and improved sedation ratings compared with sedation using midazolam and meperidine alone.