Document Detail

Does low-dose droperidol increase the risk of polymorphic ventricular tachycardia or death in the surgical patient?
MedLine Citation:
PMID:  23291623     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Food and Drug Administration issued a black box warning regarding the use of droperidol and the potential for torsade de pointes.
METHODS: The primary objective of this retrospective study was to determine if low-dose (0.625 mg) droperidol administration was associated with episodes of torsade de pointes in the general surgical population during the 3-yr period following the reinstitution of droperidol to our institutional formulary.
RESULTS: The authors identified 20,122 surgical patients who received 35,536 doses of droperidol. These patients were cross-matched with an electrocardiogram database and an adverse outcome database. The charts of 858 patients were reviewed, including patients with documentation of prolonged QTc (>440 ms) from March 2007 to February 2011, polymorphic ventricular tachycardia (VT) within 48 h of receiving droperidol, or death within 7 days of receiving droperidol. Twelve surgical patients had VT (n = 4) or death (n = 8) documented within 48 h of droperidol administration. No patients developed polymorphic VT or death due to droperidol administration (n = 0). The eight patients that died were on palliative care. The four patients with documented VT had previous cardiac conditions: two had pre-existing implantable cardiac defibrillators, three had episodes of VT before receiving droperidol, and another had pre-existing hypertrophic obstructive cardiomyopathy. The authors found 523 patients with a documented QTc >440 ms before receiving droperidol. No patients developed VT or death as a direct result of droperidol administration.
CONCLUSIONS: Our evidence suggests that low-dose droperidol does not increase the incidence of polymorphic VT or death when used to treat postoperative nausea and vomiting in the surgical population.
Gregory A Nuttall; Ann M Malone; Carrie A Michels; Laurie C Trudell; Tricia D Renk; Mary E Shirk Marienau; William C Oliver; Michael J Ackerman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  118     ISSN:  1528-1175     ISO Abbreviation:  Anesthesiology     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-23     Completed Date:  2013-07-08     Revised Date:  2013-10-07    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  382-6     Citation Subset:  AIM; IM    
Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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MeSH Terms
Aged, 80 and over
Antiemetics / administration & dosage,  adverse effects*,  therapeutic use
Databases, Factual
Droperidol / administration & dosage,  adverse effects*,  therapeutic use
Electrocardiography / drug effects
Heart Diseases / complications
Hospital Mortality
Middle Aged
Postoperative Nausea and Vomiting / prevention & control
Retrospective Studies
Surgical Procedures, Operative / mortality*
Tachycardia, Ventricular / chemically induced*,  epidemiology*,  mortality
Torsades de Pointes / chemically induced*,  epidemiology*,  mortality
Reg. No./Substance:
0/Antiemetics; 548-73-2/Droperidol
Comment In:
Anesthesiology. 2013 Sep;119(3):730-1   [PMID:  23962938 ]
Anesthesiology. 2013 Sep;119(3):730   [PMID:  23962937 ]

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