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Droperidol versus haloperidol en náuseas y vómito posoperatorios: un análisis retrospectivo.

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Title: Droperidol versus haloperidol en náuseas y vómito posoperatorios: un análisis retrospectivo.
Alternate Title: Droperidol versus haloperidol on postoperative nausea and vomiting: a retrospective analysis.
Authors: Young, Maia C.1, Ajayi, Omolola2, Naranjo, Julian3, Martin McGrew, Yvette N.3, Schroeder, Darrell R.4, Sprung, Juraj3, Weingarten, Toby N.3 weingarten.toby@mayo.edu
Source: Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología. Jul-Sep2025, Vol. 53 Issue 3, p1-8. 8p.
Subjects: POSTOPERATIVE nausea & vomiting, HALOPERIDOL, POSTOPERATIVE care, ANTIEMETICS, RETROSPECTIVE studies, DOPAMINE antagonists, SEDATIVES
Abstract (English): Introduction: Butyrophenones are effective prophylactic drugs against postoperative nausea and vomiting (PONV). Our practice used droperidol for PONV prophylaxis until supply chain issues in 2020 required a substitution to haloperidol. Objective: To compare the use of these two butyrophenones and their association with the magnitude of reduction PONV and sedation during admission to postanesthesia care unit (PACU). Methods: Retrospective review of the records of adult surgical patients administered a butyrophenone and admitted to the PACU, from May 2018 through December 2022. PONV was defined as administration of rescue antiemetics during PACU admission. Inverse probability of treatment weighing (IPTW) analysis was performed using generalized estimating equations with robust variance estimates to assess the effects of droperidol and haloperidol on PONV rate. Results: We identified 905 (2018 – 2020) and 651 patients (2020 – 2022) receiving droperidol or haloperidol, respectively. The IPTW PONV rate was 75 (8.3%) for droperidol and 84 (12.9%) haloperidol (odds ratio 0.60; 95% confidence interval 0.41 to 0.87, for the use of droperidol vs haloperidol). Moderate or higher levels of sedation (Richmond Agitation Sedation Scale score ≤ -3) was noted in 163 (18.0) of droperidol and 102 (15.7%) of haloperidol patients, which was nonsignificant, P=0.222, following IPTW adjustment, P=0.269. Median [interquartile range] PACU length of stay was comparable for two butyrophenones, 70 [51, 99] vs. 68 [48, 105] minutes for droperidol vs haloperidol, respectively, P=0.647. Conclusions: Droperidol was associated with lower rates of PONV during PACU admission than haloperidol, but the rate of sedation was higher. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: Las butirofenonas son medicamentos profilácticos efectivos contra las náuseas y el vómito posoperatorios (NVPO). En la práctica de los autores de este artículo utilizaron droperidol para la profilaxis de NVPO hasta que los problemas de la cadena de suministro en 2020 requirieron una sustitución por haloperidol. Objetivo: Comparar el uso de estas dos butirofenonas y su asociación con la magnitud de la reducción de NVPO y la sedación durante la admisión a la unidad de cuidados posanestésicos (UCPA). Métodos: Revisión retrospectiva de los registros de pacientes quirúrgicos adultos a los que se les administró una butirofenona y fueron admitidos en la UCPA entre mayo de 2018 y diciembre de 2022. La presencia de NVPO se definió como condición para administrar antieméticos de rescate durante la admisión a la UCPA . Se realizó un análisis de ponderación de probabilidad inversa de tratamiento (IPTW, por sus siglas en inglés) utilizando ecuaciones de estimación generalizadas con estimaciones de varianza robusta para evaluar los efectos de droperidol y haloperidol en la tasa de NVPO. Resultados: Se identificaron 905 pacientes (2018-2020) y 651 pacientes (2020-2022) que recibieron droperidol o haloperidol, respectivamente. La tasa de NVPO IPTW fue de 75 (8,3 %) para droperidol y 84 (12,9 %) para haloperidol (razón de probabilidades 0,60; intervalo de confianza del 95 % [0,41-0,87], para el uso de droperidol vs. haloperidol). Se observaron niveles moderados o superiores de sedación (escala de sedación/agitación de Richmond ≤ -3) en 163 (18,0 %) de los pacientes con droperidol y 102 (15,7 %) de los pacientes con haloperidol, lo cual no fue significativo, p=0,222, después del ajuste IPTW, p=0,269. La mediana [rango intercuartílico] de la duración de la estancia en la UCPA fue comparable para las dos butirofenonas, 70 [51, 99] vs. 68 [48, 105] minutos para droperidol vs. haloperidol, respectivamente, p=0,647. Conclusiones: El droperidol se asoció con tasas más bajas de NVPO durante la admisión a la UCPA que el haloperidol, pero la tasa de sedación fue mayor. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Introduction: Butyrophenones are effective prophylactic drugs against postoperative nausea and vomiting (PONV). Our practice used droperidol for PONV prophylaxis until supply chain issues in 2020 required a substitution to haloperidol. Objective: To compare the use of these two butyrophenones and their association with the magnitude of reduction PONV and sedation during admission to postanesthesia care unit (PACU). Methods: Retrospective review of the records of adult surgical patients administered a butyrophenone and admitted to the PACU, from May 2018 through December 2022. PONV was defined as administration of rescue antiemetics during PACU admission. Inverse probability of treatment weighing (IPTW) analysis was performed using generalized estimating equations with robust variance estimates to assess the effects of droperidol and haloperidol on PONV rate. Results: We identified 905 (2018 – 2020) and 651 patients (2020 – 2022) receiving droperidol or haloperidol, respectively. The IPTW PONV rate was 75 (8.3%) for droperidol and 84 (12.9%) haloperidol (odds ratio 0.60; 95% confidence interval 0.41 to 0.87, for the use of droperidol vs haloperidol). Moderate or higher levels of sedation (Richmond Agitation Sedation Scale score ≤ -3) was noted in 163 (18.0) of droperidol and 102 (15.7%) of haloperidol patients, which was nonsignificant, P=0.222, following IPTW adjustment, P=0.269. Median [interquartile range] PACU length of stay was comparable for two butyrophenones, 70 [51, 99] vs. 68 [48, 105] minutes for droperidol vs haloperidol, respectively, P=0.647. Conclusions: Droperidol was associated with lower rates of PONV during PACU admission than haloperidol, but the rate of sedation was higher. [ABSTRACT FROM AUTHOR]
ISSN:01203347
DOI:10.5554/22562087.e1147