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Effectiveness of combined haloperidol and dexamethasone versus dexamethasone only for postoperative nausea and vomiting in high-risk day surgery patients: a randomized blinded trial.

Author(s): Chaparro LE, Gallo T, Gonzalez NJ, Rivera MF, Peng PW

Affiliation(s): Department of Anesthesia, University of Antioquia, IPS Universitaria, Medellin, Colombia. luisdr74@yahoo.com

Publication date & source: 2010-02, Eur J Anaesthesiol., 27(2):192-5.

Publication type: Comparative Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

BACKGROUND AND OBJECTIVE: To examine whether prophylactic use of haloperidol in addition to dexamethasone decreased the incidence of postoperative nausea and vomiting in high-risk patients undergoing ambulatory surgery. METHODS: One hundred and sixty nonsmoking women aged between 18 and 50 years receiving a standardized anaesthesia, which included dexamethasone 8 mg at the beginning of cosmetic or ENT surgery, were enrolled. They were randomized to receive either 1.5 mg of haloperidol (dexamethasone-haloperidol group) or placebo (dexamethasone-placebo group) 30 min before the end of surgery. The incidence of postoperative nausea and vomiting was assessed by a blinded investigator at 30 min, 2, 6, and 24 h in the postoperative period. Analgesic requirements, eye opening time, and sedation were also assessed. RESULTS: We found no differences in nausea or vomiting at 30 min and 2 h postoperatively; we found no difference in the incidence of nausea between dexamethasone-haloperidol and dexamethasone-placebo groups at 6 h [relative risk (RR) 0.82, 95% confidence interval (CI) 0.56-1.25] and 24 h (RR 0.79, 95% CI 0.56-1.1), but the cumulative incidence of vomiting in the dexamethasone-haloperidol group was significantly lower at 6 h (RR 0.57, 95% CI 0.39-1.05) and 24 h (RR 0.54, 95% CI 0.31-0.86). We found no differences in eye opening time and Ramsay score higher than 2 at 30 min and 2 h after surgery. CONCLUSION: To combine 1.5 mg of haloperidol and 8 mg of dexamethasone reduces the cumulative incidence of postoperative vomiting at 6 and 24 h postoperatively in day patients at high risk of postoperative nausea and vomiting.

Page last updated: 2010-10-05

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