Bottom Line: Droperidol is an effective alternative to haloperidol in the treatment of gastroparesis although most patients will also receive prokinetic agents as well such as metoclopramide. It may also have some analgesic benefit.
Prior studies have demonstrated the efficacy and safety of haloperidol in the management of gastroparesis. A recent retrospective study was conducted to assess the impact of droperidol as it is an effective antiemetic similar to haloperidol.
This study enrolled 233 patients. Visits were matched with their most recent ED visit > 7 prior where droperidol was not administered.
Most patients were female, 51% African American, and the median age was 40. Doses ranged from 0.625 mg – 2.5 mg with the most common dose being 1.25 mg.
Results:
46% of the droperidol visits received opioids compared to 60% when droperidol was not given (p=0.004)
Droperidol was noted to reduce pain scores from 9 (IQR 7-10) to 5 (IQR 0-8) (p=0.0001)
Droperidol visits were prescribed fewer antiemetic agents 60% vs 73% (p=0.0045)
There was no difference in the use of prokinetic agents (metoclopramide)
No difference in ED or hospital LOS or admission rates (~30%), cost, or adverse events
References
Stirrup N, Jones G, Arthus J, Lewis Z. Droperidol undermining gastroparesis symptoms (DRUGS) in the emergency department. American Journal of Emergency Medicine. 2024;75:42-45.
