Adding Droperidol to Morphine Patient-Controlled Anal
gesia : Effect on Nausea and Vomitingt
VIMOLLUCK SANANSILP, M.D.*, SUWIT SOONTARINKA, M.D.*,
PRANEET KANTIGAL, M.D.*, SHUSEE VISAL YAPUTRA, M.D.*,
JIDAPA DEESAWAT,B.Sc.*, PHANSAMON PHADERMWONGSA, B.N.*,
SUDTA PARAKKAMODOM, B.N.*, SIRILUK VUDHIKAMRAKSA, B.N.*
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
t This study was supported by Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractThis prospective, double-blind, randomized, controlled trial was performed to evaluate the
antiemetic effectiveness and side effects of adding droperidol to morphine delivered via a patient
controlled analgesia (PCA) device in 94 women undergoing transabdominal hysterectomy with a
standardized anesthetic regimen. They were randomly allocated to receive postoperative PCA as
either bolus doses of morphine 1 mg or a combination of morphine 1 mg and 0.0625 mg droperidol
with a lockout interval of 5 minutes and no continuous infusion. The incidence of nausea 6-18 hours
postoperatively and 18-24 hours postoperatively was significantly lower in the morphine and dro
peridol group than in the morphine only group and its severity 2-6 hours, 6-18 hours, and 18-24
hours postoperatively was significantly lower. The number needed to treat to prevent nausea com
paring the morphine only group at 6-18 and at 18-24 hours postoperatively were 4 and 4 (95% CI
2-27 and 2-11, respectively). The amount of morphine used 6-18 hours postoperatively in the dro
peridol group was lower than in the morphine only group. Although the incidence of vomiting and
the amount of rescue antiemetics were lower in the morphine and droperidol group, the difference
was not statistically significant. Postoperative pain scores were not different between the groups.
No patients were oversedated. A series of extrapyramidal reactions were observed in one patient in
the morphine and droperidol group. The drug and consumable item cost was not different between
the groups. We conclude that droperidol added to morphine in PCA reduces nausea. The appropriate
dose of droperidol should be further investigated to reduce the incidence of vomiting.
Keywords : PCA, Droperidol, Morphine, PONY, Postoperative Analgesia, Nausea, Vomiting
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