Journal Article

Droperidol administration among emergency department patients with abdominal pain, nausea, and vomiting

Mainor, Hannah, Madsen, Troy, Ernst, Ryan, Smith, Mckayla, O'Brien, Liam, Wagstaff, Holden

2024

Overview

The primary objective of this study was to examine the common usage patterns of droperidol in the relatively unrestricted environment of an urban, academic medical center. We focused specifically on the most common use of droperidol in our department: patients with a chief complaint of abdominal pain, nausea, and/or vomiting. For this retrospective, observational, single-center study, we extracted records of all administrations of droperidol from August 2019 to August 2020. Patients with a chief complaint of abdominal pain, nausea, or vomiting, or any combination thereof, were included in data analysis. Between April 2019 to August 2020, 830 discrete patient visits involving droperidol administration were identified, comprising 706 patients. The average age was 39 years old with a range of 15 to 80. Seven patients (0.08%) were younger than 18, and 35 (4%) were older than 65. Five hundred sixty-five patients (68%) were female. Droperidol doses ranged from 0.625 mg to 5 mg intravenous (IV), with a median dose of 0.625 mg (interquartile range 0.625–1.25 mg), with 590 patients (71%) receiving a dose of 0.625 mg. Only 19 patients (2.3%) had a documented adverse event. Seven had akathisia or restlessness, 7 had anxiety or agitation, 3 had dystonia or stiffness, 1 had fatigue, and 1 had dizziness. For the entire cohort, there were no cardiac dysrhythmias, syncope, seizures, other major adverse events, or fatalities recorded. At one institution, droperidol is being used commonly for the chief complaints of abdominal pain, nausea, and/or vomiting. The preferred dosing is nearly universally below the 2.5 mg IV dose for which the FDA warning applies. Similar to previous studies, identification of adverse events was rare, and no major adverse outcomes such as dysrhythmia or death were identified. •The indications for which droperidol is commonly used are abdominal pain, nausea, and vomiting.•Droperidol is commonly being used at doses well below the dose for which the FDA black box warning applies.•Side effects of IV droperidol at commonly used doses are both rare and minor.•No major side effects, including no deaths, associated with droperidol were noted in this study.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Abdomen / Abdominal pain / Abdominal Pain - drug therapy / Adolescent / Adult / Adverse events / Aged / Aged, 80 and over / Akathisia / Antiemetics / Antiemetics - administration & dosage / Antiemetics - adverse effects / Antiemetics - therapeutic use / Black box / Complaints / Descriptive labeling / Dosage / Droperidol / Droperidol - administration & dosage / Droperidol - adverse effects / Droperidol - therapeutic use / Drug dosages / Dystonia / Emergency / Emergency medical care / Emergency medical services / Emergency Service, Hospital / FDA / FDA approval / Female / Headaches / Humans / Male / Medical records / Middle Aged / Narcotics / Nausea / Nausea - chemically induced / Nausea - drug therapy / Pain / Patients / Physicians / Retrospective Studies / Seizures / Syncope / Vomiting / Vomiting - chemically induced / Young Adult