McKeage Kate, Simpson Dene, Wagstaff Antona J
Wolters Kluwer Health-Adis, 41 Centorian Drive, Mairangi Bay, Auckland 1311, New Zealand.
Drugs. 2006;66(16):2123-47. doi: 10.2165/00003495-200666160-00009.
Droperidol (Dehydrobenzperidol, Dehidrobenzoperidol, Dridol, Droleptan, Inapsine) is a dopamine D(2) receptor antagonist that has been widely used in adults and children for the prevention and treatment of postoperative nausea and vomiting (PONV) over several decades and, more recently, for the prevention of opioid-induced PONV during patient-controlled analgesia (PCA) in adults. In well controlled clinical trials of patients undergoing surgery, the efficacy of single-dose intravenous (IV) droperidol in preventing PONV was similar to that of ondansetron and dexamethasone. Droperidol significantly reduced opioid-induced PONV in adults during PCA and had a morphine-sparing effect. Droperidol is generally well tolerated and the incidence of adverse effects is similar to that observed with placebo and the serotonin 5-HT(3) receptor antagonists (setrons). Guidelines recommend that, in adults, droperidol monotherapy be considered for those at moderate risk of PONV, and droperidol in combination with a setron and/or dexamethasone be considered for patients at moderate or high risk of PONV. In children with moderate or high risk of PONV, droperidol is recommended for first-line use in some countries, and second-line use in others.
氟哌利多（脱氢苯哌利多、去氢苯哌利多、达罗哌丁苯、羟哌利多、英诺辛）是一种多巴胺D(2)受体拮抗剂，几十年来已广泛用于成人和儿童预防和治疗术后恶心和呕吐（PONV），最近还用于预防成人患者自控镇痛（PCA）期间的阿片类药物引起的PONV。在对接受手术患者进行的严格对照临床试验中，单剂量静脉注射（IV）氟哌利多预防PONV的疗效与昂丹司琼和地塞米松相似。氟哌利多在PCA期间可显著降低成人阿片类药物引起的PONV，并具有节省吗啡的作用。氟哌利多一般耐受性良好，不良反应发生率与安慰剂和5-羟色胺5-HT(3)受体拮抗剂（司琼类）相似。指南建议，对于中度PONV风险的成人，可考虑氟哌利多单药治疗；对于中度或高度PONV风险的患者，可考虑氟哌利多与一种司琼和/或地塞米松联合使用。在PONV中度或高度风险的儿童中，在一些国家推荐氟哌利多一线使用，在其他国家则为二线使用。
