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Low-dose droperidol versus standard-dose droperidol for prevention of postoperative vomiting after pediatric
R E Brown1, D J James, R G Weaver
1Department of Anesthesia, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
Insights
A low dose of droperidol (20 microgram/kg) is as effective as a high dose (75 microgram/kg) in preventing postoperative vomiting in pediatric strabismus surgery patients. The lowest effective dose is recommended to minimize potential sedation.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) is a common complication following pediatric strabismus surgery.
- Droperidol is an antiemetic used to manage PONV.
- The optimal dosage of droperidol for PONV prevention in this population is not well-established.
Purpose of the Study:
- To compare the efficacy of a low dose (20 microgram/kg) versus a high dose (75 microgram/kg) of droperidol in preventing vomiting after pediatric strabismus surgery.
- To evaluate the impact of different droperidol doses on recovery time and postoperative examination.
- To determine the lowest effective dose of droperidol for PONV prophylaxis in pediatric patients.
Main Methods:
- A randomized, double-blind study was conducted.
- One hundred children undergoing strabismus surgery were randomly assigned to three groups.
- Groups received either droperidol 75 mcg/kg, droperidol 20 mcg/kg, or a saline placebo.
Main Results:
- Children receiving droperidol (both doses) experienced less frequent vomiting compared to the placebo group (p = 0.0521).
- No significant difference in vomiting frequency was observed between the low-dose and high-dose droperidol groups.
- There was no statistically significant difference in recovery room stay duration among the groups.
Conclusions:
- A low dose of droperidol (20 mcg/kg) is as effective as a high dose (75 mcg/kg) for preventing postoperative vomiting in pediatric strabismus surgery.
- The lowest effective dose of droperidol should be considered to mitigate potential side effects like sedation.
- Further research may be needed to fully assess the impact on recovery room stay.
Study Objective:
To determine whether a low dose of droperidol is as effective as a high dose in preventing vomiting after pediatric strabismus surgery.
Design:
Randomized, double-blind study.
Setting:
Operating room and recovery room at a university medical center.
Patients:
One hundred children undergoing strabismus procedures.
Interventions:
Patients were divided randomly into three groups and received either droperidol 75 microgram/kg, droperidol 20 microgram/kg, or saline.
Measurements And Main Results:
Vomiting was assessed in all groups, as was time to discharge and ability to perform a satisfactory postoperative eye examination. Children who received droperidol vomited less frequently than those who did not (p = 0.0521). There was no difference in the frequency of vomiting between the two groups that received droperidol.
Conclusion:
Droperidol 20 microgram/kg is as effective as droperidol 75 microgram/kg in preventing vomiting after pediatric strabismus surgery. Because higher doses of droperidol may sedate some patients, the lowest effective dose should be used. In this study, however, there was no statistically significant difference with regard to length of recovery room stay.