Preoperative droperidol improved postoperative pain relief in patients undergoing rotator-cuff repair during general anesthesia using intravenous morphine

Morphine sparing with droperidol in patient-controlled analgesia

“…In 1995, Freedman et al [4] showed that droperidol 125 lg coadministered with 1.9 mg morphine under background infusion of the mixture prevented PONV and reduced postoperative morphine consumption. Yamamoto et al [5] also demonstrated that preoperative administration of droperidol 10 lg/kg improves postoperative pain relief and reduces analgesic consumption. Our results were comparable, implying that droperidol provides a morphine-sparing effect on postoperative pain management.…”

“…Previous reports indicate that droperidol is effective in the treatment of postoperative nausea and vomiting (PONV) [3], and few researchers have failed to address its synergistic or additive analgesic effects with respect to pain management. Some workers have demonstrated a morphine-sparing effect with concomitant lowdose droperidol in morphine patient-controlled analgesia (PCA) for postoperative pain management [4] and also a reduction in postoperative pain intensity and analgesic consumption with preoperative droperidol 10 lg/kg [5]. Hence, in this controlled, double-blind, prospective study, we evaluated this morphine-sparing effect by combining droperidol with morphine in PCA.…”

Morphine sparing with droperidol in patient-controlled analgesia

“…This analgesic property of droperidol is relatively unknown and its mechanism unclear, although it has already been observed in patients undergoing rotator-cuff repair surgery [2]. The results of both studies suggest that droperidol might be administered systematically to any patient undergoing general anesthesia and requesting patient-controlled analgesia with morphine not only to lower the incidence of postoperative nausea and vomiting, but also to diminish the incidence of other side effects of morphine, such as respiratory depression.…”

“…One of the reasons that make surgeons and us hesitate to give patients nonsteroidal anti-inflammatory drugs (NSAIDs) is postoperative wound bleeding. Recent articles suggested that adding NSAIDs to morphine patient-controlled analgesia has the possibility of increasing the risk for postoperative bleeding [2,3]. Although the conclusion needed further studies and review, the cost/benefit balance should be considered.…”

Advances in the use of intravenous techniques in ambulatory anesthesia

“…1,34 Non-opioid medications such as NSAIDs (PO and IV), intravenous acetaminophen, COX-2 inhibitors, local anesthetics, ketamine, alpha-2-agonists, pregabalin, gabapentin, dextromethorphan, and even magnesium, may be utilized as a part of a multimodal approach to perioperative pain management 45 rather than aggressive use of opioid analgesics. 66,77 Other intravenous medications, which do not confer analgesic benefits such as antiemetics (droperidol) 78 and glucocorticoids (dexamethasone, 79 betamethasone, 80 methylprednisolone) 81 are of great benefit in reducing side effects in the postoperative period. Novel therapies like capsaicin, derived from chili peppers, have been established to provide analgesic benefits secondary to the effect in altering the nociceptive input at peripheral nerve ending.…”