Droperidol and/or Ondansetron

MCKENZIE, RAY; Uy, Nonita T. Lim; Riley, Theodore J.; Hamilton, Dana L.

doi:10.1213/00000539-199706000-00044

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…There is some evidence of an increased anti-emetic efficacy with a combination of droperidol and ondansetron in the surgical setting. 114,115 Further research is needed to establish optimal doses of this combination. Metoclopramide, however, is a molecule, which acts at both dopamine and 5-HT 3 receptors, and which theoretically combines the anti-emetic properties of droperidol and ondansetron, did not show any clinically relevant antiemetic efficacy in the surgical setting at the doses currently used (i.e.…”

Section: Dizziness a N D V E R T I G Omentioning

confidence: 99%

Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting

Henzi

Sonderegger

Tramèr

2000

Can J Anesth/J Can Anesth

217

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Purpose: To estimate the efficacy and harm produced by droperidol in the prevention of postoperative nausea and vomiting (PONV). Methods: Systematic search (MEDLINE, EMBASE, Cochrane library, hand-searching, bibliographies, all languages, up to May 1999) for randomised comparisons of droperidol with placebo in surgical patients. Relevant end points were prevention of early PONV (up to six hours postoperatively), and late PONV (24 hr), and adverse effects. Combined data were analysed using relative risk and NNT. Results: In 76 trials, 5,351 patients received 24 different regimens of droperidol. The average incidence of early and late PONV in controls was 34% and 51%, respectively. Droperidol was more efficacious than placebo in preventing PONV. In adults, the anti-nausea effect was short-lived, and there was no dose-responsiveness; with 0.25 to 0.30 mg the number-needed-to-treat (NNT) to prevent early nausea was 5. For both early and late anti-vomiting efficacy there was dose-responsiveness; best efficacy was with 1.5 mg to 2.5 mg (NNT, 7). In children, there was dose-responsiveness; best efficacy was with 75 µg·kg -1 (NNT to prevent early and late vomiting, 4). Two children had extrapyramidal symptoms with droperidol (NNT in children, 91; in any patient, 408). There was dose-responsiveness for sedation and drowsiness (with 2.5 mg the NNT was 7.8). Droperidol prevented postoperative headache (NNT,. Conclusions: Droperidol is anti-emetic in the surgical setting. The effect on nausea is short-lived but more pronounced than the effect on vomiting. Sedation and drowsiness are dose-dependent, extrapyramidal symptoms are rare, and there is a protective effect against headache.Objectif : Évaluer l'efficacité et les effets négatifs du dropéridol utilisé pour la prévention de nausées et de vomissements postopératoires (NVPO). Méthode : Recherche documentaire systématique (MEDLINE, EMBASE, bibliothèque Cochrane, recherche manuelle, bibliographies, dans toutes les langues jusqu'à mai 1999) pour établir des comparaisons randomisées de dropéridol avec un placebo chez des patients de chirurgie. Les paramètres étudiés ont été la prévention des NVPO précoces (jusqu'à six heures après l'opération) et tardifs (24 h) et les effets indésirables. Les données combinées ont été analysées en utilisant le risque relatif et le nombre nécessaire au traitement (NNT). Résultats : Résultats : Pour 76 essais, 5 351 patients ont reçu 24 régimes différents de dropéridol. L'incidence moyenne de NVPO précoces et tardifs chez les témoins a été de 34 % et 51 %, respectivement. Le dropéridol a été plus efficace que le placebo pour prévenir les NVPO. Chez les adultes, l'effet anti-nausée a été de courte durée et il n'y a pas eu de réponse en fonction de la dose; avec 0,25 à 0,30 mg, le NNT pour prévenir les nausées précoces a été de 5. Pour prévenir efficacement les vomissements précoces et tardifs, il y avait une réponse dépendante de la dose; la plus efficace a été de 1,5 mg à 2,5 mg (NNT, 7). Chez les enfants, pas de réponse selon la dose; l'effica...

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Section: Dizziness a N D V E R T I G Omentioning

confidence: 99%

Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting

Henzi

Sonderegger

Tramèr

2000

Can J Anesth/J Can Anesth

217

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“…Ondansetron lowers the PONV incidence range to 20 to 45 % [10][11][12] and only has minor transient side effects. 13,14 Droperidol lowers the PONV incidence range to 22 to 60% 15,16 and is associated with sedation, hypotension, and extrapyramidal reactions. 1 7 The many causes of PONV may be better addressed by antagonizing more than one class of receptors through the use of a combination of anti-emetic drugs.…”

mentioning

confidence: 99%

Additive anti-emetic efficacy of prophylactic ondansetron with droperidol in out-patient gynecological laparoscopy

Belo

Koutsoukos

2000

Can J Anesth/J Can Anesth

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Purpose: To determine the efficacy of ondansetron and droperidol, alone and in combination, administered for prophylaxis of postoperative nausea and vomiting (PONV) in women undergoing general anesthesia for outpatient gynecological laparoscopy.Methods: Following Institutional Ethics Board approval and patient consent, 160 female out-patients scheduled for laparoscopy were randomly allotted in a double-blind fashion to receive: i) saline (placebo), ii) 4 mg ondansetron, iii) 1.25 mg droperidol, or iv) 4 mg ondansetron and 1.25 mg droperidol combination intravenously on induction. Following a standardized general anesthesia, patients were interviewed and assessed for PONV at various times.Results: During the first 24 hr after surgery, the incidence of PONV in the placebo group was 71%. This was reduced to 61% with droperidol alone (P = 0.334), to 46% with ondansetron alone (P = 0.027), and to 23% with the combination group (P < 0.001). A statistically significant difference was observed between combination and droperidol (P < 0.001) and between combination and ondansetron (P = 0.036). There were fewer requests for rescue medication from the combination group (7.7%) than from the ondansetron and placebo groups. Conclusion:The results of this study suggest that the combination of 4 mg ondansetron and 1.25 mg droperidol is more efficacious as a prophylactic anti-emetic than either agent alone during the 24 hr post-surgery. This additive effect may be due to the different mechanisms of action of ondansetron and droperidol.Objectif : Déterminer l'efficacité de l'ondansétron et du dropéridol, seuls ou combinés, administrés comme prophylaxie des nausées et vomissements postopératoires (NVPO) chez des patientes sous anesthésie générale lors d'une laparoscopie gynécologique en clinique externe.Méthode : Après avoir obtenu l'autorisation du Comité d'éthique médicale et le consentement des patientes, on a procédé à l'étude de 160 femmes, réparties au hasard en double aveugle, qui ont reçu avant la laparoscopie ambulatoire prévue : i) une solution salée (placebo), ii) 4 mg d'ondansétron, iii) 1,25 mg de dropéridol, ou iv) une combinaison intraveineuse de 4 mg d'ondansétron et de 1,25 mg de dropéridol à l'induction de l'anesthésie. Après l'anesthésie générale standard, les patientes ont été interrogées sur les NVPO à différents temps.Résultats : Pendant les 24 premières heures postopératoires, l'incidence des NVPO ont été de 71 % dans le groupe placebo. Cette incidence a été réduite à 61% avec de dropéridol employé seul (P = 0,334), à 46 % avec l'ondansétron seul (P = 0,027) et à 23 % avec la combinaison des deux médicaments (P < 0,001). Une différence statistiquement différente a été observée entre la combinaison et le dropéridol (P < 0,001) et entre la combinaison et l'ondansétron (P = 0,036). On enregistre moins de demandes de médication de rattrapage provenant des patientes qui ont reçu la combinaison de médicaments (7,7 %) que de celles qui ont reçu l'ondansétron ou le placebo.Conclusion : Les résultats de l'étude suggèr...

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“…In the delayed phase, the anti-emetic eect of metoclopramide monotherapy may be mediated by a combined blockage of 5-HT 3 , dopamine D 2 and D 3 receptors. Recent clinical and experimental studies also showed that postoperative nausea and vomiting are not completely inhibited by dopamine receptor antagonists or 5-HT 3 receptor antagonists, but a combination of these two antiemetics was more eective than the monotherapy (Wynn et al, 1993;McKenzie et al, 1996;Wu et al, 2000). In the present study, we demonstrate that AS-8112 is a potent dopamine D 2 , D 3 and 5-HT 3 receptors antagonist and is a highly potent antiemetic against emesis induced by various emetogens.…”

Section: British Journal Of Pharmacology Vol 133 (2)mentioning

confidence: 99%

“…Recently, clinical and experimental studies demonstrated that the combination of a dopamine D 2 and a 5-HT 3 receptor antagonist was more eective against postoperative nausea and vomiting than the monotherapy (McKenzie et al, 1996;Wynn et al, 1993;Wu et al, 2000). Therefore, there is a clear need for the development of dual dopamine D 2 and 5-HT 3 receptor antagonists which exert a broad-spectrum of anti-emetic activity.…”

Section: Introductionmentioning

confidence: 99%

The broad‐spectrum anti‐emetic activity of AS‐8112, a novel dopamine D₂, D₃ and 5‐HT₃ receptors antagonist

Yoshikawa

Yoshida

Oka

2001

British J Pharmacology

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1 The anti-emetic and pharmacological pro®le of AS-8112 ((R)-5-bromo-N-(1-ethyl-4-methylhexahydro-1H-1,4-diazepin-6-yl)-2-methoxy-6-methylamino-3-pyridinecarboxamide×2 fumarate), a novel and potent dopamine D 2 , D 3 and 5-hydroxytryptamine-3 (5-HT 3 ) receptors ligand, was investigated in the present study. 2 In guinea-pig isolated colon, AS-8112 produced a rightward shift of the concentration-response curves of 2-methyl-5HT, a 5-HT 3 receptor agonist (pA 2 value of 7.04). Other 5-HT 3 receptor antagonists also produced such a shift in the following antagonistic-potency order: granisetron4 ondansetron=AS-811244metoclopramide.

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Droperidol and/or Ondansetron

Cited by 3 publications

References 8 publications

Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting

Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting

Additive anti-emetic efficacy of prophylactic ondansetron with droperidol in out-patient gynecological laparoscopy

The broad‐spectrum anti‐emetic activity of AS‐8112, a novel dopamine D₂, D₃ and 5‐HT₃ receptors antagonist

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Droperidol and/or Ondansetron

Cited by 3 publications

References 8 publications

Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting

Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting

Additive anti-emetic efficacy of prophylactic ondansetron with droperidol in out-patient gynecological laparoscopy

The broad‐spectrum anti‐emetic activity of AS‐8112, a novel dopamine D2, D3 and 5‐HT3 receptors antagonist

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The broad‐spectrum anti‐emetic activity of AS‐8112, a novel dopamine D₂, D₃ and 5‐HT₃ receptors antagonist