Podcast 865: Nausea Treatments - Droperidol vs Ondansetron RCT

<p dir="ltr"><strong>Contributor: Aaron Lessen MD</strong></p> <p dir="ltr"><strong>Educational Pearls:</strong></p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">A recent randomized controlled trial compared ondansetron 8 mg IV with droperidol 2.5 mg IV for the treatment of nausea & vomiting in the emergency department. </p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Overall, droperidol and ondansetron had similar primary outcomes in acute nausea control </p> </li> <ul> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">Symptom improvement in 93% of patients receiving droperidol vs. 87% receiving ondansetron (P = 0.362)</p> </li> </ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Secondary measures were, however, statistically significantly different between groups</p> </li> <ul> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">Patients needed fewer rescue/additional antiemetics in the droperidol group (16%) compared with the ondansetron group (37%); p = 0.016</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">Similarly, more patients in the droperidol group reported they achieved the desired effect of the medication (85% vs. 63%; p = 0.006)</p> </li> </ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Patients receiving droperidol did experience increased drowsiness</p> </li> <ul> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">40% in the droperidol group vs. 11% in the ondansetron group</p> </li> </ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">The trial did not assess the length of stay in the ED after administering medications, which is a potential avenue for future research.</p> </li> </ul> <p dir="ltr"><strong>References</strong></p> <p dir="ltr">1. Philpott L, Clemensen E, Lau GT. Droperidol versus ondansetron for nausea treatment within the emergency department. EMA - Emerg Med Australas. 2023;(December 2022):605-611. doi:10.1111/1742-6723.1