Haloperidol Versus Ondansetron for Prophylaxis of Postoperative Nausea and Vomiting

• Published in: Anesthesia and analgesia Vol. 106; no. 5; pp. 1407 - 1409
• Main Authors: Rosow, Carl E., Haspel, Kenneth L., Smith, Sarah E., Grecu, Loreta, Bittner, Edward A.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01.05.2008; Lippincott
• Subjects: Adult; Aged; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antiemetics - adverse effects; Antiemetics - therapeutic use; Biological and medical sciences; Elective Surgical Procedures; Female; Haloperidol - adverse effects; Haloperidol - therapeutic use; Heart Conduction System - drug effects; Humans; Male; Medical sciences; Middle Aged; Ondansetron - adverse effects; Ondansetron - therapeutic use; Postoperative Nausea and Vomiting - prevention & control; Receptors, Serotonin, 5-HT3 - metabolism; Serotonin 5-HT3 Receptor Antagonists; Serotonin Antagonists - adverse effects; Serotonin Antagonists - therapeutic use; Treatment Outcome; Postoperative; Neuroleptic; Psychotropic; Dopamine antagonist; Serotonin antagonist; Butyrophenone derivatives; Nausea; Haloperidol; Prevention; D2 Dopamine receptor; Vomiting; 5-HT3 Serotonine receptor; Digestive diseases; Anesthesia; Antiemetic; Comparative study; Ondansetron
• ISSN: 0003-2999; 1526-7598; 1526-7598
• DOI: 10.1213/ane.0b013e3181609022

Haloperidol is effective for postoperative nausea and vomiting prophylaxis, but there are almost no data comparing it to 5-HT(3) antagonists. Two hundred forty-four adults were randomized to receive i.v. haloperidol 1 mg or ondansetron 4 mg, during general anesthesia. Nausea, vomiting, need for rescue, sedation, extrapyramidal effects, QTc intervals, and time to postanesthesia care unit discharge were evaluated with a third-party blind design. There was no intergroup difference in any measure of efficacy or toxicity. Haloperidol and ondansetron subjects (78.2% and 76.8%) had complete response. Postoperatively, prolonged QTc occurred in 28.9% and 22.1% (N.S.). In a mixed surgical population, the efficacy and toxicity of postoperative nausea and vomiting prophylaxis with haloperidol 1 mg was not significantly different from ondansetron 4 mg.