Haloperidol is as effective as ondansetron for preventing postoperative nausea and vomiting.
OBJECTIVE
Recent warnings regarding the safety of droperidol have limited use of this drug as an antiemetic. Haloperidol, a butyrophenone derivative similar to droperidol, has not been rigorously evaluated as an antiemetic. The aim of this study was to compare the prophylactic antiemetic efficacy of haloperidol vs ondansetron for the prevention of postoperative nausea and vomiting (PONV) after general anesthesia.


METHODS
Ninety non-smoking female patients were eligible to participate in this randomized double-blinded study. Approximately 30 min before the end of surgery, patients were randomly assigned to receive either haloperidol 2 mg iv, or ondansetron 4 mg iv, respectively. The incidence of PONV, average pain and sedation scores, recovery times, and changes of the rate-corrected QT (QTc) interval were observed postoperatively.


RESULTS
The proportion of patients who experienced PONV in the first 24 hr was similar in the two groups (28% and 26% for haloperidol and ondansetron groups, respectively). The incidence of PONV was significantly less in both groups than predicted according to the patients' underlying risks (53% for the haloperidol group, P=0.016; 51% for the ondansetron group, P=0.015). Pain scores, sedation scores, and recovery times were similar in the two groups, and no prolongation of the QTc interval was observed in either group.


CONCLUSIONS
Haloperidol 2 mg iv given 30 min before the end of surgery is effective in preventing PONV, with efficacy comparable to ondansetron 4 mg iv for the first 24 hr after general anesthesia.
Lee
Yi
Y
Department of Anesthesiology, Buddhist Tzu-Chi Medical Center, Tzu-Chi University School of Medicine, Hualien, Taiwan, ROC.
Wang
Po K
PK
Lai
Hsien Y
HY
Yang
Yao L
YL
Chu
Chin C
CC
Wang
Jhi J
JJ
D000328:Adult; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000932:Antiemetics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
D000932:Antiemetics; D017294:Ondansetron; D006220:Haloperidol