Effectiveness of combined haloperidol and dexamethasone versus dexamethasone only for postoperative nausea and vomiting in high-risk day surgery patients: a randomized blinded trial.
OBJECTIVE
To examine whether prophylactic use of haloperidol in addition to dexamethasone decreased the incidence of postoperative nausea and vomiting in high-risk patients undergoing ambulatory surgery.


METHODS
One hundred and sixty nonsmoking women aged between 18 and 50 years receiving a standardized anaesthesia, which included dexamethasone 8 mg at the beginning of cosmetic or ENT surgery, were enrolled. They were randomized to receive either 1.5 mg of haloperidol (dexamethasone-haloperidol group) or placebo (dexamethasone-placebo group) 30 min before the end of surgery. The incidence of postoperative nausea and vomiting was assessed by a blinded investigator at 30 min, 2, 6, and 24 h in the postoperative period. Analgesic requirements, eye opening time, and sedation were also assessed.


RESULTS
We found no differences in nausea or vomiting at 30 min and 2 h postoperatively; we found no difference in the incidence of nausea between dexamethasone-haloperidol and dexamethasone-placebo groups at 6 h [relative risk (RR) 0.82, 95% confidence interval (CI) 0.56-1.25] and 24 h (RR 0.79, 95% CI 0.56-1.1), but the cumulative incidence of vomiting in the dexamethasone-haloperidol group was significantly lower at 6 h (RR 0.57, 95% CI 0.39-1.05) and 24 h (RR 0.54, 95% CI 0.31-0.86). We found no differences in eye opening time and Ramsay score higher than 2 at 30 min and 2 h after surgery.


CONCLUSIONS
To combine 1.5 mg of haloperidol and 8 mg of dexamethasone reduces the cumulative incidence of postoperative vomiting at 6 and 24 h postoperatively in day patients at high risk of postoperative nausea and vomiting.
Chaparro
Luis E
LE
Department of Anesthesia, University of Antioquia, IPS Universitaria, Medellín, Colombia. luisdr74@yahoo.com
Gallo
Tatiana
T
Gonzalez
Nelson J
NJ
Rivera
Maria F
MF
Peng
Philip W
PW
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods; D000768:Anesthesia, General / Q000379:methods; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D000932:Antiemetics; D003907:Dexamethasone; D006220:Haloperidol