The use of droperidol decreases postoperative nausea and vomiting after gynecological laparoscopy

Abstract

We evaluated whether or not routine prophylaxis with 2.5 mg of droperidol would efficiently prevent postoperative nausea and vomiting (PONV). Fifty-two patients scheduled for elective gynecological laparoscopic surgery were eligible for this study. Anesthesia was induced using propofol, fentanyl, and vecuronium, and maintained with sevoflurane in nitrous oxide, fentanyl, and vecuronium. Patients were randomized to one of two groups: group 1 patients (n = 23) received 2.5 mg droperidol intravenously when the surgery was started, while group 2 patients (n = 29) did not receive any droperidol. At the conclusion of the surgery, the patient was extubated on satisfactory emergence from general anesthesia. Any episodes of nausea and vomiting, rescue medications, and adverse effects were recorded until the next morning after the surgery. There were no differences in the duration of anesthesia on surgery between the groups, but the total fentanyl dose in group 1 was higher than that in group 2. Episodes of nausea and vomiting and the need for metoclopramide in group 1 were lower than in group 2, though the total fentanyl dose in group 1 was higher than in group 2. There were no differences in the need for analgesics between the groups. The use of 2.5 mg droperidol safely decreased PONV after gynecological laparoscopy.

A Randomized Comparison of Droperidol, Metoclopramide, Tropisetron, and Ondansetron for the Prevention of Postoperative Nausea and Vomiting

“…Williams et al [25] applied patient-controlled analgesia with morphine in patients who had abdominal hysterectomies and in the treatment of postoperative pain; they reported that droperidol was effective in preventing PONV. Gan et al [14] found droperidol and patient-controlled analgesia effective in preventing PONV after orthopedic surgery; these results were similar to those found after gynecologic operations [26,27]. Droperidol which affects the QT interval has been reported to cause cardiac complications [28,29].…”

“…Williams et al [25] found droperidol to be effective in preventing PONV, but its sedation effect was more apparent. Mitsunari et al [26] found no side effects from droperidol. Bolton et al [35] detected sedation in 1 of 84 cases with droperidol, and Kovac [32] reported sedation in 7% of 580 cases in a multicenter study.…”

“…McKenzie et al [34] compared a group receiving a combination of ondansetron (4 mg) and droperidol (1.25 mg) with a group receiving only droperidol (1.25 mg); the group receiving combination therapy had less PONV than the group receiving only droperidol. Mitsunari et al [26] found ondansetron superior to metoclopramide and droperidol in gynecologic operations. In our study, severe PONV was seen less frequently with ondansetron administration than in controls.…”

Comment on Ekinci et al.: A Randomized Comparison of Droperidol, Metoclopramide, Tropisetron, and Ondansetron for the Prevention of Postoperative Nausea and Vomiting

“…In the discussion the authors stated that Mitsunari et al [5] found ondansetron to be superior to metoclopramide and droperidol. How should these investigators come to this result when they only investigated droperidol in the prevention of PONV?…”