BACKGROUND: Droperidol (DHB) reportedly reduces the dose of propofol needed to achieve hypnosis when anesthesia is induced and decreases the bispectral index (BIS) in propofol-sedated patients during spinal anesthesia. We reported previously that supplemental DHB decreased the BIS after the administration of sevoflurane and remifentanil. This study investigated the effect of DHB on desflurane (DES) consumption in a clinical setting. METHODS: We conducted a prospective, randomized double-blinded study of 35 women with American Society of Anesthesiologist physical status I or II who underwent a mastectomy. Either DHB (20 µg/kg) or a saline placebo was administered to patients 30 min after the induction of anesthesia. A blinded anesthesiologist maintained a BIS value of 50 during anesthesia by modulating inhaled DES concentrations that changed 0.5% at 2.5 min intervals and maintained analgesia via the constant administration of remifentanil by referring to vital signs. The primary endpoint was the effect of DHB on DES consumption. The secondary endpoints included blood circulatory parameters, the time from the end of surgery to extubation, and discharge time between the groups. RESULTS: The characteristics of the patients did not differ between the groups. The DHB group used a mean of 27.2 ± 6.0 ml of DES compared with 41.4 ± 9.5 ml by the placebo group (P < 0.05). CONCLUSIONS: A small dose of DHB reduced the DES concentration needed to maintain a BIS of 50. Our results show that DHB reduced the consumption of DES without adverse effects.
Analgesia ; Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Breast Neoplasms* ; Breast* ; Droperidol* ; Female ; Humans ; Hypnosis ; Mastectomy ; Propofol ; Prospective Studies ; Vital Signs

BACKGROUND: 5-HT3 receptor antagonist, dexamethasone and droperidol were used for the prevention of postoperative nausea and vomiting (PONV). Recently, neurokinin-1 (NK1) antagonist has been used for PONV. We evaluated the effect of oral aprepitant premedication in addition to ondansetron. METHODS: A total 90 patients scheduled for elective rhinolaryngological surgery were allocated to three groups (Control, Ap80, Ap125), each of 30 at random. Ondansetron 4 mg was injected intravenously to all patients just before the end of surgery. On the morning of surgery, 80 mg and 125 mg aprepitant were additionally administered into the Ap80 group and Ap125 group, respectively. The rhodes index of nausea, vomiting and retching (RINVR) was checked at 6 hr and 24 hr after surgery. RESULTS: Twelve patients who used steroids unexpectedly were excluded. Finally 78 patients (control : Ap80 : Ap125 = 24 : 28 : 26) were enrolled. Overall PONV occurrence rate of Ap125 group (1/26, 3.9%) was lower (P = 0.015) than the control group (7/24, 29.2%) at 6 hr after surgery. The nausea distress score of Ap125 group (0.04 +/- 0.20) was lower (P = 0.032) than the control group (0.67 +/- 1.24) at 6 hr after surgery. No evident side effect of aprepitant was observed. CONCLUSIONS: Oral aprepitant 125 mg can be used as combination therapy for the prevention of PONV.
Dexamethasone ; Droperidol ; Humans ; Morpholines ; Nausea ; Ondansetron ; Postoperative Nausea and Vomiting ; Premedication ; Receptors, Neurokinin-1 ; Receptors, Serotonin, 5-HT3 ; Steroids ; Vomiting

OBJECTIVETo observe the clinical effect of acupoint injection with small dose of fentanyl-droperido mixed liquor at different time stages on labor analgesia, and explore its function mechanism.

METHODSOne hundred and fifty cases of full-term primiparas who were intended to take vaginal delivery were randomly divided into 3 groups, 50 cases in each one. The acupoint injection with fentanyl-droperido mixed liquor at different time stages was applied in the group I, where Shenshu (BL 23) was selected in active phase and Ciliao (BL 32) was selected in the 2nd stage of labor. The subcutaneous injection with fentanyl-droperido mixed liquor was adopted in group II. The group III, which was considered as a control group, was treated with subcutaneous injection of 0.9% NaCl at the same time stage as group I and II. The blood pressure, VAS score and level of norepinephrine and adrenaline were observed at different time stages.

RESULTSCompared before the injection, the blood pressure of group III in the active phase and 2nd stage of labor was significantly increased (P < 0.05), and that in group II and III was obviously higher than that in the group I (P < 0.05). The VAS score of group I in the active phase and 2nd stage of labor was significantly lower than that in the group II and III (P < 0.01). After the injection, the level of NE and E was significantly decreased (P < 0.05), which was lower than that in the group II and III (P < 0.05).

CONCLUSIONThe acupoint injection with small dose of fentanyl-droperido mixed liquor at different time stages has positive effect on labor analgesia, and it could significantly relieve stress reaction of parturient during the labor. Its mechanism could be related to the reduction of stress hormone in parturient.

Acupuncture Points ; Adult ; Analgesia, Obstetrical ; Analgesics ; administration & dosage ; Delivery, Obstetric ; Droperidol ; administration & dosage ; Female ; Fentanyl ; administration & dosage ; Hormones ; metabolism ; Humans ; Labor Pain ; drug therapy ; Labor, Obstetric ; metabolism ; Pregnancy ; Young Adult

BACKGROUND: Haloperidol, a major tranquilizer similar to droperidol, has been found to have a potent antiemetic effect on postoperative nausea and vomiting (PONV), but the supporting evidence was incomplete, especially in Korea.Therefore we evaluated the prophylactic effect of haloperidol on opioid-based IV patient-controlled analgesia (PCA) related PONV in susceptible patients after gynecological laparoscopic surgery. METHODS: Ninety-six adult women scheduled gynecological laparoscopic surgery were enrolled in a randomized, double-blinded and placebo study.Patients received haloperidol 1 mg (Group H) or saline (Group C) 30 min before the end of surgery.Fentanyl-based IV PCA was administered after surgery.The incidences and severity of nausea, vomiting, rescue antiemetic administration, pain, and adverse effects (cardiac arrhythmias and extrapyramidal effects) were assessed for 24 h after surgery.The sedation score was recorded in the post-anesthesia care unit for 2 h. RESULTS: The incidences and severity of nausea and the number of antiemetic administration were significantly lower in Group H than Group C (P < 0.05). But the sedation and pain score were similar. There was no QTc prolongation or extrapyramidal symptom in both groups. CONCLUSIONS: Prophylactic haloperidol 1 mg is effective in preventing PONV related to fentanyl-based IV PCA, with less adverse effects, in patients undergoing gynecological laparoscopic surgery.
Adult ; Analgesia, Patient-Controlled ; Antiemetics ; Arrhythmias, Cardiac ; Droperidol ; Female ; Haloperidol ; Humans ; Incidence ; Laparoscopy ; Nausea ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Vomiting

OBJECTIVETo investigate the method for preventing the postoperative nausea and vomiting (PONV) after laparoscopic gynecologic surgery.

METHODSOne hundred and twenty patients being for laparoscopic gynecologic surgery at I- II grade as American Society of anesthesiologists (ASA) were randomly divided into three groups, 40 cases in each group. Twenty minutes before the operation, the mixture of 2. 5 mg Droperidol (1 mL) and 1 mL 0. 9% sodium chloride solution was injected into the bilateral Neiguan (PC 6) in group I , and an intravenous injection with 1 mL Droperidol was used in group II , while there was no treatment carried out in group Ill'. Twenty four hours after the operation, the frequency and degree of nausea and vomiting were observed and scored according to the criteria standard.

RESULTSThe incidence rate of nausea was 10. 0% (4/40) in group I , 57. 5% (23/40) in group II , which was significantly different from 80. 0% (32/40) in group III (P<0. 01, P<0. 05, respectively), while it was lower in group I than in group II (P<0. 01). The incidence rate of vomiting was 7. 5% (3/40) in group I , 52. 5% (21/40) in group II , which was significantly different from 75.0% (30/40) in group III (P<0.01, P<0.05 respectively), while it was lower in group I than in group II (P<0.01). No complication, such as obvious drowsiness, anxiety and extracorticospinal tract reaction, was observed among the three groups.

CONCLUSIONAcupoint injection at Neiguan (PC 6) with a small dose of Droperidol can effectively prevent the PONV after laparoscopic gynecologic surgery without other adverse effects.

Acupuncture Points ; Adult ; Aged ; Droperidol ; administration & dosage ; Female ; Gynecologic Surgical Procedures ; adverse effects ; Humans ; Injections ; Laparoscopy ; adverse effects ; Middle Aged ; Postoperative Nausea and Vomiting ; drug therapy ; prevention & control ; Young Adult

OBJECTIVETo investigate the influence of dopamine (DA) and DA receptor's antagonist on the transmission of noxious information in the central nervous system of normal rats or morphinistic rats.

METHODSThe influence of DA on the electric activity of the pain-excited neuron (PEN) in the caudate nucleus (Cd) of normal rats or morphinistic rats was recorded after the sciatic nerve was noxiously stimulated.

RESULTSDA shortened the average latency of the evoked discharge of PEN in the Cd of normal rats, indicating that DA could increase the activity of PEN and pain sensitivity in normal rats. This effect could be inhibited by Droperidol. DA increased the average latency of the evoked discharge of PEN in the Cd of morphinistic rats, indicating that DA could inhibit the activity of PEN and pain sensitivity in morphinistic rats.

CONCLUSIONThe responses to painful stimulation were completely opposite between normal rats and morphinistic rats after the intracerebroventricular injection of DA.

Action Potentials ; drug effects ; physiology ; radiation effects ; Analysis of Variance ; Animals ; Caudate Nucleus ; drug effects ; Disease Models, Animal ; Dopamine ; pharmacology ; Dopamine Antagonists ; pharmacology ; Droperidol ; pharmacology ; Drug Interactions ; Electric Stimulation ; adverse effects ; Female ; Male ; Morphine Dependence ; physiopathology ; therapy ; Neurons ; drug effects ; Pain ; drug therapy ; etiology ; physiopathology ; Pain Threshold ; drug effects ; Rats ; Rats, Wistar ; Reaction Time ; drug effects ; physiology ; radiation effects

BACKGROUND: Epidural opioids are used for the treatment of postoperative pain, but the incidence of side effects like nausea, vomiting, and pruritus is high. The aim of this study was to determine the optimal method for administering epidural droperidol to reduce the side effects of epidural opioids. METHODS: A randomly sampled group of 145 patients that had undergone abdominal or lower leg surgery under general anesthesia were divided into the four groups. All patients received morphine 4 mg, fentanyl 500microgram and 0.2% ropivacaine 100 ml using a 2-day epidural infusion pump, and morphine 1 mg, fentanyl 50 mg and 0.2% ropivacaine 10 ml by epidural bolus. Group 1 patients (control group, n = 40) did not receive epidural droperidol. Group 2 patients (n = 35) received 2.5 mg of droperidol as an epidural bolus. Group 3 patients (n = 35) received 2.5 mg of droperidol as a continuous infusion. Group 4 patients (n = 35) received 1.25 mg of droperidol as an epidural bolus and 1.25 mg of droperidol as a continuous infusion simultaneously. Nausea, vomiting, and pruritus were assessed and recorded by a blind observer 1, 6, 24, and 48 hours after the bolus epidural administration of droperidol. RESULTS: There was no significant difference between the four groups in terms of the intensity of sedation, nausea, vomiting, and pruritus. The incidence of nausea and vomiting in groups 2, 3, and 4 at 1 hour, in groups 2 and 4 at 6 hours, and in groups 3 at 48 hours was significantly lower than in control group. The incidences of pruritus in groups 2, 3, and 4 at 6 hours, and in groups 3 and 4 at 24 and 48 hours were significantly less than that of the control group. CONCLUSIONS: Epidural bolus droperidol is effective at reducing nausea, and vomiting during the early postoperative stage. Continuous epidural droperidol is also effective at reducing the pruritus during the late postoperative stage.
Analgesics, Opioid ; Anesthesia, General ; Droperidol* ; Fentanyl ; Humans ; Incidence ; Infusion Pumps ; Leg ; Morphine ; Nausea ; Pain, Postoperative ; Pruritus ; Vomiting

Patient-controlled analgesia (PCA) is an important means for postoperative analgesia with parenteral opioid. However, postoperative nausea and vomiting (PONV) remains a major problem with a PCA system. Droperidol is used in PCA to prevent PONV. Extrapyramidal reactions by droperidol are, however, occasionally induced. We describe two cases of severe extrapyramidal hypertonic syndrome with an intravenous administration of droperidol in PCA in young patients, following orthopedic surgery.
Acute Disease ; Adolescent ; Analgesia, Patient-Controlled/*adverse effects ; Analgesics/administration & dosage/*adverse effects ; Droperidol/administration & dosage/*adverse effects ; Dystonia/*chemically induced ; Humans ; Infusions, Intravenous ; Male

BACKGROUND: This study was designed to compare the antiemetic effects of propofol, ondansetron, droperidol and metoclopramide for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing middle ear surgery. METHODS: One-hundred-twenty patients were scheduled for middle ear surgery (tympanomastoidectomy and tympanoplasty). Patients received propofol (0.5 mg/kg), ondansetron (60microgram/kg), droperidol (20microgram/kg) or metoclopramide (0.2 mg/kg) intravenously at the end of the surgical procedure. The assesment of PONV was performed during 3 periods after receiving anesthesia; 0 to 2 hours in the postanesthetic care unit, 2 to 12 hours and 12 to 24 hours in the ward. RESULTS: The percentage of no emesis during the 0 to 2 hour period after receiving anesthesia was 93% for the those who received propofol, 73% for the those who received ondansetron, 70% for the those who received droperidol, and 70% for the those who received metoclopramide. The respective corresponding incidence during the 2 to 12 hour period after receiving anesthesia was 86%, 66%, 63%, and 63%, and the respective corresponding incidence during the 12-24 hour period after receiving anesthesia was 90%, 66%, 66%, and 66%. No clinically adverse events were observed in any of the groups. CONCLUSIONS: A small dose of propofol is a better antiemetic than ondansetron, droperidol or metoclopramide for prevention of postoperative nausea and vomiting after middle ear surgery.
Anesthesia ; Antiemetics* ; Droperidol* ; Ear, Middle* ; Equidae ; Humans ; Incidence ; Metoclopramide* ; Ondansetron* ; Postoperative Nausea and Vomiting ; Propofol* ; Vomiting

BACKGROUND: We compared the antiemetic efficacy of droperidol, granisetron, and propofol in postoperative nausea and vomiting (PONV) in the patients who received epidural anesthesia with bupivacaine and morphine. METHODS: Among one hundred and sixty one ASA physical status I or II patients who received an abdominal hysterectomy under epidural anesthesia, sixty patients who showed PONV and thereby received antiemetics were randomly assigned into 3 groups: droperidol 0.75 mg (droperidol group: n = 20), granisetron 1.0 mg (granisetron group: n = 20) or propofol 20 mg (propofol group: n = 20) by an intravenous injection. Antiemetics were injected according to the patient request up to 3 times of initial dose. Nausea, vomiting, sedation, anxiety, and discomfort were assessed and the time interval between each antiemetic administration was recorded by a blind observer for 30 min after the injection of antiemetics. RESULTS: Success rates in PONV control for 30 min after the 1st antiemetic administration were 90%, 95%, and 85% in the droperidol, granisetron, and propofol group, respectively. The propofol group experienced a higher relapse incidence (90%) than other groups (droperidol: 35%, granisetron: 25%)(P<0.05). The granisetron group showed a longer time interval between the 1st and 2nd antiemetic administration (616 +/- 501 min: P<0.05) than other groups. No patients in the granisetron and propofol groups showed any anxiety and discomfort, however six patients in the droperidol group showed some anxiety and discomfort. CONCLUSIONS: All antiemetics were effective to control the PONV, but droperidol caused some anxiety and discomfort and propofol showed higher relapse incidence.
Anesthesia, Epidural ; Antiemetics ; Anxiety ; Bupivacaine ; Droperidol* ; Granisetron* ; Humans ; Hysterectomy ; Incidence ; Injections, Intravenous ; Morphine* ; Nausea ; Postoperative Nausea and Vomiting ; Propofol* ; Recurrence ; Vomiting