Comparison of Different Methods of Administering Droperidol in Patient-Controlled Analgesia in the Prevention of Postoperative Nausea and Vomiting

Gan, T. J.; Alexander, Roderick; Fennelly, M.; Rubin, Alan

doi:10.1097/00132586-199510000-00049

Cited by 11 publications

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“…A loading dose of droperidol was not used because the concomitant use of a loading dose of droperidol and its addition to a PCA morphine solution has been shown to increase sedation while having no additional benefit on the prevention of nausea and vomiting. 4 During the pre-operative assessment, all patients were instructed on the use of PCA and no premedication was prescribed. Anaesthesia was induced with 50-100 pg fentanyl followed by 4-5 mg.kg -1 thiopentone, and muscle relaxation was provided with a loading dose of 0.5-0.6 mg.kg -I atracurium or 0.1 mg.kg -1 vecuronium.…”

Section: Methodsmentioning

confidence: 99%

Comparison of tramadol and tramadol/droperidol mixture for patient-controlled analgesia

Tsui

Yang

et al. 1997

Can J Anaesth

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MBCKB FRCA FFARCSI MRcv(UK) l~I-IlCa/vl(Anaes)To compare the analgesic efficacy and side effects of tramadol vs tramadol and droperidol for post-operative patient-controlled analgesia (PCA), Method: Randomised, double-blind study. Thirty-four patients undergoing elective colorectal or head and neck surgery were allocated to Group I (n = 18, PCA bolus I 0 mg tramadol ) or Group 2 (n = 16, PCA bolus I 0 mg trarnadol + 0. I mg droperidol). Anaesthesia was induced with fentanyl and thiopentone and maintained with O 2, N20 plus enflurane or isoflurane with iv morphine at doses decided bythe attending anaesthetists. Muscle relaxal~on was achieved with atracurium or vecuronium. Patients were observed four-hourly for pain using an I l-point verbal rating scale (VRS). Nausea and vomiting, and sedation were assessed using four-point scales post-operatively. V~I signs, request for rescue anti-emetic and analgesic, and overall satisfaction were recorded. ~ults: The mean nausea scores were lower in Group 2 (I.00 • 1,33 vs 0.06 • 0.25 at 0-8 hr, 1.22 _+ 1.93 vs 0.06 + 0.25 at 8-16 hr, P < 0.01; 0.81 • 1.68 vs 0 at 32-40 hr, P < 0.05; Group 1 vs Group 2). The vomiting scores were also lower (0.50 • 1.04 vs 0 at 0--8 hr, 0.67 __ 1.50 vs 0 at 8-16 hr, P < 0.05; Group I vs Group 2). Seven (3996) patients in Group I, but none in Group 2 requested rescue anti-emetic (P < 0.01). There were no differences in VRS, sedation score, overall satisfaction or vital signs. Conclusion: Tramadol and droperidol combination is superior to tramadol alone for post-operative PCA. It provides a similar quality of analgesia with less nausea and vomiting and without an increase in sedation.Objeclif: Comparer le tramadol seul avec rassodation tramadol-clropEndol sous l'aspect de l'efficadtE et des effets secondaires lorsque administr~s pour ranalgEsie postop&atoire autocorCw61Ee (PCA). M~hodes : l~tude alEatoire en double aveugle. Trente-quatre patients soumis ~ une chirurgie Elective colorectale ou cEphalo-cervicaie ont ErE assignEs au groupe I (n= 18, PCA avec tramadol I0 mg en bolus) ou au groupe 2 (n = 16, PCA avec t~-~lol I 0 rag+ drop&idol 0, I m 8 en bolus), l'anesthEsie induite au fentanyl et au thiopentone Etait maintenue avec OJN20 et enflurane ou isoflurane et morphine/v aux doses d&idEes par l'anesthEsiste en charge. La curadsation Etait rEalisEe avec de ratracudum ou du v&uronium. AprEs rintervention, la douleur a EtE cotEe aux quatre heures sur une ckhelle verbale simple (EVS) en onze points. Les nausEes les vomissements et la sedation ont EtE estimEs sur une &helle de quatre points. Les signes vitaux, les demandes d'anti&r~tiques et d'analgEsiques, et le degrE g~n&ai de satisfaction Etaient notes. Rksultalx = Les scores moyens de nausEe Etaient infEdeurs darts le groupe 2 (I ,00 _ 1,33 vs 0,06 • 0,25 ~ 0-8 h ; 1,22 _+_ 1,93 vs 0,06 • 0,25 ,~ 8-I 6 h, P < 0,01 ; 0,81 • 1,68 vs 0 ,~ 32-40 h. P < 0,05 ; groupe I vs groupe 2). Les scores de vomissement ~taient aussi infEdeurs (0,50 _• 1,04 vs 0 ~ 0-8 h, 0,67 + I ,S0 vs 0 ~ 8-16 h, P < 0,05, ...

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Section: Methodsmentioning

confidence: 99%

Comparison of tramadol and tramadol/droperidol mixture for patient-controlled analgesia

Tsui

Yang

et al. 1997

Can J Anaesth

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“…Studies have found that the addition of droperidol (0.05-0.2 mg.ml ÿ 1 ) to morphine PCA has reduced the incidence of nausea and vomiting and, in some cases, the need for additional intramuscular anti-emetics [5,9,40,43,44]. However, some studies reported an increase in sedation associated with the use of droperidol [5,9,44] and Gan et al [45] argued that adding droperidol to PCA increases sedation with no benefit over a single dose of droperidol at the end of surgery. Moreover, although extrapyramidal side-effects were not reported in any of the studies, they should be considered, particularly if PCA is to continue beyond 24 h. Collum et al [46] report a case study of a patient experiencing a dystonic reaction Ϸ30 h after surgery and while receiving PCA morphine with droperidol 0.2 mg.ml ÿ 1 added.…”

Section: Giving Prophylactic Anti-emeticsmentioning

confidence: 99%

Nausea and vomiting in the postoperative patient‐controlled analgesia environment

Woodhouse

Mather

1997

Anaesthesia

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SummaryDespite common clinical opinion that patient-controlled analgesia should be renamed 'patientcontrolled nausea', there is little evidence in support of the notion that postoperative nausea and vomiting are exacerbated by the method. Indeed, data indicate that opioid-sparing techniques are not associated with less postoperative nausea and vomiting. Although some evidence suggests that certain opioids are less emetogenic than others, this too does not stand scrutiny when compared across patients, although research is still required to find whether individual patients are better treated with a particular opioid. Similarly, the emerging practice of combining anti-emetics with patient-controlled analgesia needs wider study before it can be supported. Nausea and vomiting are distressing adverse events which frequently follow surgery. The incidence of postoperative nausea and vomiting is difficult to estimate because of methodological differences between studies; however, there are reports of from 8% to 92% of postsurgical patients experiencing postoperative emesis [1]. Lerman [2] and Watcha & White [3] suggest that the incidence of postoperative nausea and vomiting has remained fairly constant for decades with Ϸ20-30% of patients suffering from these unpleasant side-effects. However, it is common to find reports of a much higher incidence in a variety of surgical populations [4][5][6][7][8][9][10]. Differentiation of opioidinduced nausea and vomiting from that of other perioperative factors, including those associated with uncontrolled pain [11], is difficult enough without complications introduced by patient-controlled analgesia (PCA) which allows patients to medicate on irregular and inconsistent bases. This review focuses on the issues associated with nausea and vomiting as encountered in the postoperative PCA environment.

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“…PONV after lower extremity TJA has a reported incidence of 20 to 83% [14,21]. Various antiemetic agents control PONV [8,12,13,15,16].…”

Section: Introductionmentioning

confidence: 99%

Antiemesis After Total Joint Arthroplasty: Does a Single Preoperative Dose of Aprepitant Reduce Nausea and Vomiting?

DiIorio

Sharkey

Hewitt

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Postoperative nausea and vomiting (PONV) is frequent after joint arthroplasty; in addition to causing patient distress, it interferes with early mobilization and hospital discharge. Various antiemetic agents reduce PONV, but their action is limited by a short half-life. Aprepitant, an antiemetic developed for patients receiving chemotherapy, has a duration of action much longer than other antiemetics. Questions/purposes We asked whether a single dose of preoperative aprepitant (40 mg orally) reduced postoperative nausea and vomiting after THA or TKA. Methods Fifty patients who received a preoperative dose of aprepitant (study group) were matched demographically to 50 patients who did not receive aprepitant (control group) from a group of patients undergoing THA or TKA. Patients' charts were reviewed to identify episodes of PONV, number of doses of antiemetics needed for breakthrough PONV, and length of stay. Aprepitant side effects, and complications. Results Aprepitant reduced the percentage of patients with PONV (39% of study and 70% of control patients). Moderate or severe PONV occurred in 22% of study and 40% of control patients. The number of episodes of PONV during hospitalization was 2.9 for the control group and 1.6 for the study group. Postoperatively, the control group required on average 1.3 doses of ondansetron compared with 0.6 doses for the study group. Hospital length of stay was reduced from 3.3 days for the control group and to 2.3 days for the study group. Conclusions These data suggest a single preoperative dose of aprepitant reduces the number of episodes and severity of PONV, the need for additional antiemetics, and the length of stay. Level of Evidence Level II, prognostic study. See guidelines for authors for a complete description of levels of evidence.

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Comparison of Different Methods of Administering Droperidol in Patient-Controlled Analgesia in the Prevention of Postoperative Nausea and Vomiting

Cited by 11 publications

References 0 publications

Comparison of tramadol and tramadol/droperidol mixture for patient-controlled analgesia

Comparison of tramadol and tramadol/droperidol mixture for patient-controlled analgesia

Nausea and vomiting in the postoperative patient‐controlled analgesia environment

Antiemesis After Total Joint Arthroplasty: Does a Single Preoperative Dose of Aprepitant Reduce Nausea and Vomiting?

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