Cyclizine and droperidol have comparable efficacy and side effects during patient-controlled analgesia.

Abstract

BACKGROUND:

Post-operative nausea and vomiting (PONV) is common, especially following gynaecological surgery. Patient-controlled analgesia (PCA) is frequently complicated by nausea. We assessed PONV, pain and sedation in patients receiving cyclizine or droperidol during PCA following abdominal hysterectomy in a double-blind trial.

METHODS:

Thirty women were randomised to receive either cyclizine 0.7 mg/kg or droperidol 0.04 mg/kg during surgery followed by PCA containing morphine sulphate with cyclizine 2 mg or droperidol 0.05 mg per demand. Blinded observers scored levels of nausea, sedation, anxiety and pain.

RESULTS:

Pain scores, PCA usage and supplemental antiemetic requirements were comparable. Nausea and sedation scores were similar in both groups. Two patients in each group developed refractory PONV. Pre-operative anxiety scores were similar and decreased comparably over time. Patients developing refractory emetic sequelae had a higher incidence of previous PONV. Previous PONV also predicted lower PCA medication intake despite similar demand rates, suggesting increased usage during lock-out periods.

CONCLUSION:

Prophylactic cyclizine and droperidol have similar efficacy during PCA. Neither is associated with perioperative anxiety. A minority of patients have refractory PONV during PCA. Previous PONV may predict less efficient PCA usage.

• Authors: J G Laffey, J F Boylan
• Journal: Irish journal of medical science (Ir J Med Sci) 2002 Jul-Sep Vol. 171 Issue 3 Pg. 141-4 ISSN: 0021-1265 [Print] Ireland
• PMID: 15736352 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics, Opioid
• Antiemetics
• Morphine
• Droperidol
• Cyclizine

Topics

• Analgesia, Patient-Controlled
• Analgesics, Opioid (administration & dosage)
• Antiemetics (adverse effects)
• Anxiety (prevention & control)
• Cyclizine (adverse effects)
• Double-Blind Method
• Droperidol (adverse effects)
• Female
• Humans
• Hysterectomy
• Middle Aged
• Morphine (administration & dosage)
• Pain, Postoperative (prevention & control)
• Postoperative Nausea and Vomiting (epidemiology, prevention & control)
• Premedication