Abstract
Background
Droperidol is a butyrophenone, with antiemetic, sedative, anxiolytic, and analgesic
properties. Although droperidol was once widely used in both emergency and perioperative
settings, use of the medication declined rapidly after a 2001 US Food and Drug Administration
(FDA) boxed warning called the medication's safety into question.
Objective
The purpose of this clinical review was to provide evidence-based answers to questions
about droperidol's safety and to examine its efficacy in its various clinical indications.
Discussion
Droperidol is an effective sedative, anxiolytic, analgesic, and antiemetic medication.
As a sedative, when compared with haloperidol, droperidol has faster onset, as well
as greater efficacy, in patients experiencing acute psychosis, with no increase in
adverse events. As an antiemetic, droperidol has been found to have equal or greater
efficacy in reducing nausea and vomiting than ondansetron and metoclopramide, with
similar adverse effects and the added effect of reducing the need for rescue analgesia
in these patients. As an analgesic, droperidol is effective for migraines and has
opioid-sparing effects when used to treat abdominal pain. Droperidol is a particularly
useful adjunct in patients who are opioid-tolerant, whose pain is often difficulty
to manage adequately.
Conclusions
Droperidol seems to be effective and safe, despite the boxed warning issued by the
FDA. Droperidol is a powerful antiemetic, sedative, anxiolytic, antimigraine, and
adjuvant to opioid analgesia and does not require routine screening with electrocardiography
when used in low doses in otherwise healthy patients before administration in the
emergency department.
Keywords
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Article info
Publication history
Published online: December 16, 2022
Accepted:
December 13,
2022
Received in revised form:
November 21,
2022
Received:
May 15,
2022
Publication stage
In Press Uncorrected ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
