Effect of 1 mg of prophylactic haloperidol for postoperative nausea and vomiting after gynecological laparoscopic surgery using IV patient controlled analgesia

Moon, Young Eun; Jung, Hyun Do; Ryu, Keon Hee; Moon, Dong Eon

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2010;5(1):30-34.
Published online January 30, 2010.

Effect of 1 mg of prophylactic haloperidol for postoperative nausea and vomiting after gynecological laparoscopic surgery using IV patient controlled analgesia

Young Eun Moon, Hyun Do Jung, Keon Hee Ryu, Dong Eon Moon

Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. demoon@catholic.ac.kr

Abstract

BACKGROUND
Haloperidol, a major tranquilizer similar to droperidol, has been found to have a potent antiemetic effect on postoperative nausea and vomiting (PONV), but the supporting evidence was incomplete, especially in Korea.Therefore we evaluated the prophylactic effect of haloperidol on opioid-based IV patient-controlled analgesia (PCA) related PONV in susceptible patients after gynecological laparoscopic surgery.
METHODS
Ninety-six adult women scheduled gynecological laparoscopic surgery were enrolled in a randomized, double-blinded and placebo study.Patients received haloperidol 1 mg (Group H) or saline (Group C) 30 min before the end of surgery.Fentanyl-based IV PCA was administered after surgery.The incidences and severity of nausea, vomiting, rescue antiemetic administration, pain, and adverse effects (cardiac arrhythmias and extrapyramidal effects) were assessed for 24 h after surgery.The sedation score was recorded in the post-anesthesia care unit for 2 h.
RESULTS
The incidences and severity of nausea and the number of antiemetic administration were significantly lower in Group H than Group C (P < 0.05). But the sedation and pain score were similar. There was no QTc prolongation or extrapyramidal symptom in both groups.
CONCLUSIONS
Prophylactic haloperidol 1 mg is effective in preventing PONV related to fentanyl-based IV PCA, with less adverse effects, in patients undergoing gynecological laparoscopic surgery.

Key Words: Haloperidol, Laparoscopic surgery, Patient-controlled analgesia, Postoperative nausea and vomiting