Droperidol, Fentanyl and Morphine for I.V. Surgical Premedication

Conner, J. T.; Herr, George; Katz, Ronald L.; Dorey, Fred; Pagano, R. R.; Schehl, D.

doi:10.1093/bja/50.5.463

Cited by 8 publications

(10 citation statements)

References 6 publications

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“…1 ) , Diazepam probably produces relief of anxiety without marked signs of sedation, and for morphine-scopolamine the converse situation exists, due to a more general CNS depression. This is supported by many earlier investigators (10,(16)(17)(18)(19). Thus, if the aim of the sedation is to make an unpleasant event more comfortable for the patient, the findings indicate that the patients' own estimation of tranquillization is superior to the sedation estimated by a nurse or a doctor in evaluating the desired level of sedation.…”

Section: Discussionsupporting

confidence: 63%

Comparison of Rectal Diazepam and Subcutaneous Morphine‐Scopolamine Administration for Outpatient Sedation in Minor Oral Surgery

Lundgren

1985

Acta Anaesthesiol Scand

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In a randomized cross-over study on sedation in outpatient oral surgery, subcutaneous administration of morphine-scopolamine was compared with rectal administration of diazepam. The mean dose of morphine was 0.13 mg kg-1 (range 0.13-0.24) and of diazepam 0.57 mg kg-1 (range 0.50-0.71). Apprehension, the determining factor for patients' preference for sedation method, the recovery from sedation and the postoperative course were studied. Both methods produced the desired effects. For diazepam, the effect was scored higher by the patient than the nurse observer and for morphine-scopolamine the opposite was found. Postoperative pain and patients' preference for sedation did not differ between the methods and the determining factor for the patients' preference for sedation method was the experience of stronger tranquilization. Side-effects such as prolonged recovery, nausea, dizziness, and dysphoria were frequent during the postoperative course after the morphine-scopolamine sedation but were not seen during diazepam sedation. Thus, rectal administration of diazepam should be preferred to morphine and scopolamine for sedation in minor oral surgery performed under local anesthesia.

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Section: Discussionsupporting

confidence: 63%

Comparison of Rectal Diazepam and Subcutaneous Morphine‐Scopolamine Administration for Outpatient Sedation in Minor Oral Surgery

Lundgren

1985

Acta Anaesthesiol Scand

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“…The literature search resulted in one human clinical study with quetiapine and methadone, 14 human clinical studies with droperidol combined with morphine, [26][27][28][29][30][31][32][33][34][35][36][37][38][39] two human studies investigating perphenazine or prochlorperazine combined with morphine 40,41 (Table 1), five experimental studies with acepromazine in animals, [42][43][44][45][46][47][48][49] (Table 2) and six case reports concerning quetiapine and opioids (Table 3). [50][51][52][53][54][55][56] The search initially resulted in 4321 records.…”

Section: Retrieved Studiesmentioning

confidence: 99%

“…64 Fourteen human randomized clinical trials (RCTs) investigated the conjunction of droperidol for postoperative patient-controlled analgesia (PCA) with morphine. [26][27][28][29][30][31][32][34][35][36][37][38][39] In the retrieved studies, sedation was scored on a three-or five-point scale with highest score corresponding to severe sedation, difficult or unable to arouse. In eight of the fourteen RCTs, increased sedation scores were reported when morphine and droperidol were combined compared to morphine alone.…”

Section: Sedative Effectsmentioning

confidence: 99%

Quetiapine and other antipsychotics combined with opioids in legal autopsy cases: A random finding or cause of fatal outcome?

Andersen

Simonsen

Andersen

2020

Basic Clin Pharma Tox

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Opioid poisoning is a frequent cause of death in drug addicts and occurs with opioid treatment. Quetiapine is often found in forensic autopsies and may increase the risk of fatal opioid poisoning by enhancing sedation, respiratory depression, hypotension and QT prolongation. We systematically searched for studies of acute toxicity of quetiapine or other antipsychotics combined with morphine or methadone. Case reports describing toxicity of quetiapine combined with morphine or methadone were also included. We retrieved one human study that observed pharmacokinetic interaction between quetiapine and methadone, and 16 other human studies. Fourteen investigated the combination of droperidol and morphine in treatment doses, and some indicated an additive sedative effect. Five animal studies with acepromazine in combination with morphine or methadone were located and indicated an additive effect on sedation and hypotension. Six forensic case reports in which death could have been caused solely by quetiapine, the opioid, or other drugs were found. Thus, acute toxicity of quetiapine combined with morphine or methadone has not been studied. Because of quetiapine's effects on alpha-adrenoceptors, muscarinic and histamine receptors, human ether-ago go channels and methadone kinetics, we suggest further research to clarify if the indicated additive effects of opioids and droperidol or acepromazine are also true for quetiapine.

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“…A decrease of anxiety during the period before operation is a desired function of premedication. It has been established in several studies that droperidol may actually cause an increase in anxiety in a certain number of patients when used alone (Morrison, 1970;Morrison, Clarke and Dundee, 1970;Ellis and Wilson, 1972) or in combination with a narcotic (Conner et al, 1978). Although it might seem that a drug which produces such an effect would not be used frequently by physicians, droperidol is a popular premedicant and has been found to rate highly with physicians (Stephen, 1970).…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study (Conner et al, 1978) fentanyl and morphine were studied both alone and and in combination with droperidol. The results were largely unfavourable to droperidol because of poor acceptance by the patient.…”

mentioning

confidence: 99%

Diazepam and Droperidol as I.V. Premedicants

Herr¹,

Conner²,

Katz³

et al. 1979

British Journal of Anaesthesia

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The effects of i.v. diazepam and droperidol both alone and in combination administered as premedication were studied in 240 patients. Relief of anxiety, sedation, lack of recall, acceptance by both patient and physician and side-effects were evaluated. Overall, the combination of droperidol 2.5 mg with diazepam 5 mg produced better ratings of these variables than could be achieved with either droperidol 10 mg or diazepam 10 mg alone. Larger doses of droperidol with diazepam produce an increased frequency of anxiety; larger doses of diazepam with droperidol may cause over-sedation.

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Droperidol, Fentanyl and Morphine for I.V. Surgical Premedication

Cited by 8 publications

References 6 publications

Comparison of Rectal Diazepam and Subcutaneous Morphine‐Scopolamine Administration for Outpatient Sedation in Minor Oral Surgery

Comparison of Rectal Diazepam and Subcutaneous Morphine‐Scopolamine Administration for Outpatient Sedation in Minor Oral Surgery

Quetiapine and other antipsychotics combined with opioids in legal autopsy cases: A random finding or cause of fatal outcome?

Diazepam and Droperidol as I.V. Premedicants

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