Lai Pei-Chun, Huang Yen-Ta
Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Hualien, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2018 Jan-Mar;30(1):1-4. doi: 10.4103/tcmj.tcmj_195_17.
Droperidol is a short-acting, potent dopamine D2 antagonist that can pass through the blood-brain barrier. A black box warning was issued for droperidol by the United States Food and Drug Administration in 2001 because of a risk of development of torsades de pointes induced by QT prolongation. Many experts feel that the incidence of arrhythmia is overestimated, and low-dose droperidol is almost always used by anesthesiologists for postoperative nausea and vomiting. In this review, we used evidence-based analysis to appraise high-quality studies with a low risk of bias published after 2001 on the use of droperidol in the emergency department (ED). Droperidol appears not only efficacious but also safe to treat patients with nausea/vomiting, acute psychosis, and migraine in the ED. For these conditions, droperidol may be an option for shared decision-making.
氟哌利多是一种短效、强效的多巴胺D2拮抗剂，可穿过血脑屏障。2001年，美国食品药品监督管理局对氟哌利多发布了黑框警告，因其存在因QT间期延长诱发尖端扭转型室速的风险。许多专家认为心律失常的发生率被高估了，麻醉医生几乎总是使用低剂量氟哌利多来治疗术后恶心和呕吐。在本综述中，我们采用循证分析方法，对2001年后发表的、偏倚风险较低的关于急诊科使用氟哌利多的高质量研究进行评估。氟哌利多在急诊科治疗恶心/呕吐、急性精神病和偏头痛患者时，似乎不仅有效而且安全。对于这些病症，氟哌利多可能是共同决策的一个选择。
