title: Gender-Specific Differences in Low-Dose Haloperidol Response for Prevention of Postoperative Nausea and Vomiting: A Register-Based Cohort Study.
abstract: BACKGROUND
  Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after general anesthesia and surgery, with young non-smoking females receiving postoperative opioids being high-risk patients. This register-based study aims to evaluate the effect of low-dose haloperidol (0.5 mg intravenously) directly after induction of general anesthesia to reduce the incidence of PONV in the postoperative anesthesiological care unit (PACU).
  
  
  METHODS
  Multivariable regression models were used to investigate the association between low-dose haloperidol and the occurrence of PONV using a patient registry containing 2,617 surgical procedures carried out at an university hospital.
  
  
  RESULTS
  Haloperidol 0.5 mg is associated with a reduced risk of PONV in the total collective (adjusted odds ratio = 0.75, 95% confidence interval: [0.56, 0.99], p = 0.05). The results indicate that there is a reduced risk in male patients (adjusted odds ratio = 0.45, 95% confidence interval: [0.28, 0.73], p = 0.001) if a dose of 0.5 mg haloperidol was administered while there seems to be no effect in females (adjusted odds ratio = 1.02, 95% confidence interval: [0.71, 1.46], p = 0.93). Currently known risk factors for PONV such as female gender, duration of anesthesia and the use of opioids were confirmed in our analysis.
  
  
  CONCLUSIONS
  This study suggests that low-dose haloperidol has an antiemetic effect in male patients but has no effect in female patients. A confirmation of the gender-specific effects we have observed in this register-based cohort study might have major implications on clinical daily routine.
authors.affiliation: Department of Anaesthesiology, University Hospital of Munich, Munich, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Brettner
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.|Statistical Consulting Unit Department of Statistics, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Janitza
authors.affiliation: Anaesthesia and Intensive Care Medicine Clinic, Klinikum Dritter Orden, Munich, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Prüll
authors.affiliation: Department of Anaesthesiology, University Hospital of Munich, Munich, Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Weninger
authors.affiliation: Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mansmann
authors.affiliation: Statistical Consulting Unit Department of Statistics, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Küchenhoff
authors.affiliation: Department of Anaesthesiology, University Hospital of Munich, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Jovanovic
authors.affiliation: Department of Anaesthesiology, University Hospital of Munich, Munich, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Pollwein
authors.affiliation: Department of Anaesthesiology, University Hospital of Munich, Munich, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chappell
authors.affiliation: Department of Anaesthesiology, University Hospital of Munich, Munich, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Zwissler
authors.affiliation: Department of Anaesthesiology, University Hospital of Munich, Munich, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: von Dossow
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000768:Anesthesia, General; D000932:Antiemetics / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017294:Ondansetron / Q000627:therapeutic use; D059408:Pain Management / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control*; D011184:Postoperative Period; D012042:Registries; D012044:Regression Analysis; D012737:Sex Factors; D014495:Universities
chemical_list: D000701:Analgesics, Opioid; D000932:Antiemetics; D017294:Ondansetron; D006220:Haloperidol