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 |
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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 |
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