Droperidol, alizapride and metoclopramide in the prevention and treatment of post-operative emetic sequelae

Abstract

Women (182) undergoing elective orthopaedic surgery under general anaesthesia received 100 or 200 mg alizapride, 1.25 mg droperidol, 20 mg metoclopramide or a saline placebo intravenously 5-10 min before the end of anaesthesia in a double-blind random fashion to prevent post-operative nausea and vomiting. Administration of the same anti-emetic was repeated during 24 h post-operatively if the patient complained of nausea or retched or vomited. Significantly fewer patients given any of the anti-emetics prophylactically were nauseated or vomited in comparison with patients given saline. The incidence of nausea and vomiting in the saline group was 83%, while in those patients who received an anti-emetic it was as follows: droperidol 35% (P less than 0.001 vs. saline), alizapride, 100 mg 46% (P less than 0.01), alizapride 200 mg 53% (P less than 0.05) and metoclopramide 58% (P less than 0.05). The number of patients needing an additional dose of the same substance in the post-operative period was significantly higher in the saline group (67%) than in the groups which had received droperidol (32%, P less than 0.01) and alizapride 100 mg (37%, P less than 0.05) or 200 mg (33%, P less than 0.05). The patients who received metoclopramide, however, did not differ statistically from the saline group in the treatment of nausea and vomiting. It is concluded that droperidol was the most effective, and metoclopramide the least effective, anti-emetic in this study.