Comparison of the Antiemetic Efficacy of Droperidol, Granisetron, and Propofol after Epidural Morphine

Park, Han Suk; Chung, Chan Jong; Chin, Young Jhoon

Abstract

BACKGROUND: We compared the antiemetic efficacy of droperidol, granisetron, and propofol in postoperative nausea and vomiting (PONV) in the patients who received epidural anesthesia with bupivacaine and morphine.
METHODS
Among one hundred and sixty one ASA physical status I or II patients who received an abdominal hysterectomy under epidural anesthesia, sixty patients who showed PONV and thereby received antiemetics were randomly assigned into 3 groups: droperidol 0.75 mg (droperidol group: n = 20), granisetron 1.0 mg (granisetron group: n = 20) or propofol 20 mg (propofol group: n = 20) by an intravenous injection. Antiemetics were injected according to the patient request up to 3 times of initial dose. Nausea, vomiting, sedation, anxiety, and discomfort were assessed and the time interval between each antiemetic administration was recorded by a blind observer for 30 min after the injection of antiemetics.
RESULTS
Success rates in PONV control for 30 min after the 1st antiemetic administration were 90%, 95%, and 85% in the droperidol, granisetron, and propofol group, respectively. The propofol group experienced a higher relapse incidence (90%) than other groups (droperidol: 35%, granisetron: 25%)(P<0.05). The granisetron group showed a longer time interval between the 1st and 2nd antiemetic administration (616 +/- 501 min: P<0.05) than other groups. No patients in the granisetron and propofol groups showed any anxiety and discomfort, however six patients in the droperidol group showed some anxiety and discomfort.
CONCLUSIONS
All antiemetics were effective to control the PONV, but droperidol caused some anxiety and discomfort and propofol showed higher relapse incidence.