Continuous epidural, not intravenous, droperidol inhibits pruritus, nausea, and vomiting during epidural morphine analgesia.
OBJECTIVE
To investigate whether continuous epidural droperidol and intravenous (IV) intraoperative droperidol inhibit pruritus and postoperative nausea and vomiting (PONV) during epidural morphine analgesia.


METHODS
Randomized, double-blinded, controlled study.


METHODS
Metropolitan cancer center.


METHODS
120 ASA physical status I and II patients undergoing thoracic or abdominal surgery with general anesthesia combined with epidural anesthesia.


METHODS
Patients received an intraoperative epidural injection of 2 mg morphine hydrochloride, followed postoperatively by a continuous epidural infusion of morphine hydrochloride 4 mg/day for 4 days. Patients were randomly allocated to four groups: Group A = control group, Group B = intraoperative single IV injection of droperidol (2.5 mg), Group C = postoperative continuous epidural droperidol infusion (2.5 mg/day), and Group D = intraoperative IV injection of droperidol (2.5 mg) and postoperative continuous epidural droperidol infusion (2.5 mg/day).


RESULTS
The frequency and severity of pruritus and PONV in each group were evaluated during the postoperative period. Continuous epidural infusion of droperidol significantly reduced the frequency and severity of pruritus and PONV induced by epidural morphine without causing significant side effects. Intraoperative single IV injection of droperidol was effective for PONV (p < 0.05) but not for pruritus.


CONCLUSIONS
Postoperative epidural droperidol infusion significantly decreased both the frequency and severity of pruritus and PONV during postoperative continuous epidural morphine analgesia. IV intraoperative droperidol significantly reduced the frequency and the severity of PONV but not pruritus.
Nakata
Ken
K
Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Nakamichi, Higashinari, Japan.
Mammoto
Tadanori
T
Kita
Takashi
T
Taniguchi
Hiroshi
H
Kanbara
Noriko
N
Akamatsu
Tetsuya
T
Sakai
Toshiko
T
Kishi
Yoshihiko
Y
D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D000932:Antiemetics / Q000008:administration & dosage*; D004311:Double-Blind Method; D004329:Droperidol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011537:Pruritus / Q000209:etiology / Q000517:prevention & control*; D019616:Thoracic Surgical Procedures
D000701:Analgesics, Opioid; D000932:Antiemetics; D009020:Morphine; D004329:Droperidol