UMEM Educational Pearls

Title: Droperidol: The Hack you didn't know was a hack!

Category: Gastrointestional

Keywords: Droperidol, abdominal pain (PubMed Search)

Posted: 3/13/2025 by Neeraja Murali, DO, MPH (Updated: 3/15/2025)
Click here to contact Neeraja Murali, DO, MPH

Many of us probably use droperidol for pain relief in the ED. If you don't, two recent studies highlight it's use in multimodal pain control:

-In the DRUGS study (2023), droperidol reduced opiod use (46% vs 60%), lowered pain scores (median of 9 vs 5), and decreased the need for antiemetics (60% vs 73%).  Before you ask - mean pain score wasn't reported!

-This study evaluated gastroparesis patients, with most common dose of droperidol being 1.25 mg IV

-the DREAMER study (2024) showed that pateitns receiving droperidol required fewer opiods (median 10 Morphine Milligram Equivalents vs 19.4 MME). No significant different in need for antiemetics

-This study evaluated abdominal pain patients, with 2.5 mg IV being the most common dose

Neither study found statistically significant differences in length of stay. Additionally, neither study reported major adverse effects or healthcare costs. Note that these were both single center trials as well. 

With droperidol shortages ongoing, suggestions were made to directly compare droperidol to haloperidol, with hopefully more research coming soon!

References

-Stirrup N, Jones G, Arthur J, Lewis Z. Droperidol undermining gastroparesis symptoms (DRUGS) in the emergency department. Am J Emerg Med. 2024 Jan;75:42-45. doi: 10.1016/j.ajem.2023.10.030. Epub 2023 Oct 21. PMID: 37897920.

-Townsend BR, Malka ST, Di Paola SG, Nisly AE, Gilbert BW. DRopEridol for Abdominal pain in the emergency department for Morphine Equivalent Reduction. The DREAMER study. Am J Emerg Med. 2025 Jan 4;90:31-34. doi: 10.1016/j.ajem.2024.12.082. Epub ahead of print. PMID: 39798184.