Uses

The use of droperidol in the perioperative period is presently largely restricted to its antiemetic and sedative effects. It is an effective antiemetic, ^[729] the dose for which varies between 10 and 20 µg/kg (0.6 and 1.25 mg for a 70-kg person).^[730] These doses of droperidol, given at the start of anesthesia for operations lasting 1 hour, reduce the incidence of nausea and vomiting by about 60%. When given at induction, these doses have little effect on wakeup time, but should they be given at the end of surgery, some residual hypnotic effect could result. Droperidol is also effective in pediatric patients^[731] when the drug is given orally (300 µg/kg), and the effect can be enhanced when it is combined with oral metoclopramide (0.15 mg/kg). The overall antiemetic efficacy of droperidol alone is equal to that of ondansetron; it results in an equal number of side effects but is more cost-effective.^[732] The efficacy of droperidol as an antiemetic is enhanced when used in combination with serotonin antagonists or dexamethasone, or with both.

A newer use for droperidol is as an antiemetic given as an adjunctive drug intermittently or as a continuous infusion for postoperative pain relief as part of a patient-controlled regimen.^{[714] [733]} Droperidol has also been shown to be effective in the treatment and prevention of pruritus secondary to opioid administration. It has been administered both intravenously and into the epidural space for this purpose.^{[734] [735]} When used in this fashion, droperidol also effectively reduces nausea, but it does increase sedation. The safety of epidural administration of droperidol, however, has not been fully evaluated, and it is not approved for administration by this route.