Abstract
Background
This is an updated version of the original Cochrane review published in Issue 10, 2010, on droperidol for the treatment of nausea and vomiting in palliative care patients. Nausea and vomiting are common symptoms in patients with terminal illness and can be very unpleasant and distressing. There are several different types of antiemetic treatments that can be used to control these symptoms. Droperidol is an antipsychotic drug and has been used and studied as an antiemetic in the management of postoperative and chemotherapy nausea and vomiting.
Objectives
To evaluate the efficacy and adverse events (both minor and serious) associated with the use of droperidol for the treatment of nausea and vomiting in palliative care patients.
Search methods
We searched electronic databases including CENTRAL, MEDLINE (1950‐), EMBASE (1980‐), CINAHL (1981‐) and AMED (1985‐), using relevant search terms and synonyms. The basic search strategy was ("droperidol" OR "butyrophenone") AND ("nausea" OR "vomiting"), modified for each database. We updated the search on 2 December 2009. We performed updated searches of MEDLINE, EMBASE, CENTRAL and AMED 2009 to 2013 on 19 November 2013 and of CINAHL on 20 November 2013. We also searched trial registers (metaRegister of controlled trials (www.controlled‐trials.com/mrct), clinicaltrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/)) on 22 November 2013, using the keyword "droperidol".
Selection criteria
Randomised controlled trials (RCTs) of droperidol for the treatment of nausea or vomiting, or both, in adults receiving palliative care or suffering from an incurable progressive medical condition.
Data collection and analysis
We judged the potential relevance of studies based on their titles and abstracts, and obtained studies that we anticipated might meet the inclusion criteria. Two review authors independently reviewed the abstracts for the initial review and four review authors reviewed the abstracts for the update to assess suitability for inclusion. We discussed discrepancies to achieve consensus.
Main results
The 2010 search strategy identified 1664 abstracts (and 827 duplicates) of which we obtained 23 studies in full as potentially meeting the inclusion criteria. On review of the full papers, we identified no studies that met the inclusion criteria.
The updated searches carried out in November 2013 identified 304 abstracts (261 excluding duplicates) of which we obtained 18 references in full as potentially meeting the inclusion criteria. On review of the full papers, we identified no studies that met the inclusion criteria, therefore there were no included studies in this review.
We found no registered trials of droperidol for the management of nausea or vomiting in palliative care.
Authors' conclusions
Since first publication of this review, no new studies were found. There is insufficient evidence to advise on the use of droperidol for the management of nausea and vomiting in palliative care. Studies of antiemetics in palliative care settings are needed to identify which agents are most effective, with minimum side effects.
Plain language summary
Droperidol for the treatment of nausea and vomiting (sickness) in people with advanced disease
Nausea (a feeling of sickness) and vomiting are common and distressing symptoms for people with advanced cancer and other life‐threatening illnesses. Several medications to control these symptoms are available. Droperidol is one example, which has been used to try to prevent or treat nausea and vomiting for people having surgery or chemotherapy. In our search updated in November 2013 we found no randomised studies of droperidol for the treatment of nausea or vomiting for people receiving palliative care or suffering from an incurable progressive medical condition. Several studies reported on the use of droperidol for the prevention of nausea and vomiting associated with chemotherapy. Further studies are needed to find out which medications are most suitable to treat nausea and vomiting in palliative care.
Background
This is an updated version of the original Cochrane review published in Issue 10, 2010, on droperidol for the treatment of nausea and vomiting in palliative care patients.
Nausea and vomiting are common symptoms in patients with terminal illness and can be very distressing.
Between 40% and 70% of patients with advanced cancer are thought to suffer from nausea or vomiting (Twycross 1998), and these symptoms are also common in other terminal conditions (Edmonds 2001; Klinkenberg 2004). Antiemetic drugs can help control symptoms while the medical team undertakes an assessment of the patient and tries to treat the underlying cause. There are many such causes in patients with terminal illness, including the underlying illness (for example, bowel obstruction or metastases in the liver), biochemical disturbance (for example, renal failure or hypercalcaemia) or drugs (for example, when starting morphine). Several causes of nausea and vomiting may coexist in an individual patient. Doctors try to choose the best first choice antiemetic based on what is thought to be the underlying cause (Bentley 2001), using a second line antiemetic if the first is not effective. An antiemetic such as levomepromazine, which has effect at several receptors relevant to nausea and vomiting, is often used as a second line antiemetic.
Whilst the choice of first line antiemetic based on the likely cause of symptoms is a widespread approach, there is little evidence from randomised controlled trials for many of the drugs used for these symptoms in this patient group (for example, cyclizine, haloperidol or levomepromazine) (Davis 2010; Glare 2004).
Droperidol is one example of an antiemetic that may be used to try to reduce nausea and vomiting (Rhodes 2001). It is in the butyrophenone class of drugs and acts as a dopamine antagonist at the chemoreceptor trigger zone in the brain (Mannix 2004). Theoretically, therefore, it should be effective for biochemical causes of nausea or to reduce the emetic effect of drugs such as morphine, which is mediated through the chemoreceptor trigger zone. Haloperidol is another example of a butyrophenone and its use in this context has been systematically reviewed separately (Perkins 2009). Droperidol is used alone or together with other antiemetics orally, intravenously or intramuscularly.
In the UK, droperidol is available as an injection (2.5 mg in 1 mL), licensed for intravenous use for the prevention and treatment of postoperative nausea and vomiting (PONV) or the prevention of nausea and vomiting induced by morphine derivatives during postoperative patient‐controlled analgesia (PCA). For PONV the dose is 0.625 mg to 1.25 mg in adults (0.625 mg for the elderly or those with renal or hepatic impairment). For use with PCA in adults, the dose is 15 to 50 micrograms of droperidol per mg of morphine, up to a maximum daily dose of 5 mg of droperidol. There are no data on PCA for patients with renal or hepatic impairment in the Summary of Product Characteristics (SPC).
The United States Food and Drug Administration issued a black box warning in 2001 following concerns about QT interval prolongation and deaths due to cardiac arrhythmia with the use of droperidol (Food and Drug Administration 2001). This decision has been the focus of debate (Habib 2008; Kao 2003; Ludwin 2008; Nuttall 2007). The UK Medicines and Healthcare products Regulatory Authority (MHRA) raised concerns about the potential effect of droperidol on the QT interval and requested a risk‐benefit analysis, which led to the voluntary withdrawal of some formulations of droperidol by Jansen‐Cilag (MHRA 2001). The MHRA subsequently granted marketing authorisation for droperidol to the pharmaceutical company ProStrakan, in January 2008 (MHRA 2008).
Droperidol is also known by its trade names Droleptan (Australia, New Zealand), Inapsine (US, Canada), Xomolix (UK), Droperdal (Brazil), Dehydrobenzperidol (Belgium, Luxembourg), Droperol (India), Sintodian (Italy), Dridol (Norway, Sweden), Inapsin (South Africa), Paxical (South Africa) and Dehidrobenzperidol (Spain, Portugal) (Martindale 2009).
The medical literature regarding droperidol as an antiemetic relates primarily to its use intravenously in the prevention of postoperative nausea and vomiting or chemotherapy‐associated nausea and vomiting. We wanted to establish whether there was any evidence to support its use in the palliative care setting.
All patients with terminal illness should have access to palliative care, independent of their diagnosis, and we wish to reflect this in our review. Defining this population has been identified as a problem in previous reviews. We used the definition 'adult patients in any setting, receiving palliative care or suffering an incurable progressive medical condition', which has previously been used in a Cochrane review (Hirst 2001).
Objectives
To evaluate the efficacy and adverse events (both minor and serious) associated with the use of droperidol for the treatment of nausea and vomiting in palliative care patients.
Methods
Criteria for considering studies for this review
Types of studies
Randomised controlled trials (RCTs) of droperidol for the treatment of nausea or vomiting, or both, in any setting.
Types of participants
Inclusion criteria
Adults receiving palliative care or suffering from an incurable progressive medical condition. Adults suffering from nausea or vomiting, or both.
Exclusion criteria
Nausea or vomiting, or both, thought to be secondary to pregnancy or surgery; antiemetic(s) used for the prophylaxis of nausea or vomiting associated with chemotherapy.
Types of interventions
We included studies where droperidol was used to treat nausea or vomiting (alone or in addition to other agents) including any dose of droperidol, via any route, over any duration of follow‐up.
Acceptable comparators
Placebo
Other drug
Non‐pharmacological intervention
Types of outcome measures
Primary outcomes
Nausea rating: intensity, duration (the patient's report of his or her symptoms)
Vomiting severity rating (the patient's report of his or her symptoms)
Secondary outcomes
Quality of life measurement
Acceptability of treatment
Need for rescue antiemetic medication
Adverse events (including sedation, rigidity, tremor and cardiovascular side effects)
Withdrawal from study because of side effects
Search methods for identification of studies
We searched electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL and AMED, using relevant search terms and synonyms. The basic search strategy was ("droperidol" OR "butyrophenone") AND ("nausea" OR "vomiting"), modified for each database. Handsearching complemented the electronic searches (using reference lists of included studies, relevant chapters and review articles). We did not impose a language restriction on studies. The MEDLINE search strategy is shown in Appendix 1. The search was undertaken on 23 November 2007 and updated 16 June 2009 and again on 2 December 2009.
We performed updated searches of MEDLINE, EMBASE, CENTRAL and AMED 2009 to 2013 on 19 November 2013 and of CINAHL on 20 November 2013.
We also searched trial registers (metaRegister of controlled trials (www.controlled-trials.com/mrct), clinicaltrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/)) on 22 November 2013, using the keyword "droperidol".
Data collection and analysis
We judged the potential relevance of studies based on their titles and abstracts, and obtained studies that we anticipated might meet the inclusion criteria. Two review authors independently reviewed the abstracts for the initial review and four review authors reviewed the abstracts for the update to assess suitability for inclusion. We discussed discrepancies to achieve consensus. For the initial review, a translator enabled us to assess whether two Japanese papers identified by the search met the inclusion criteria for the review (Fujii 1987; Niijima 1986). We planned to assess the quality of included papers using the Jadad criteria (Jadad 1996).
Results
Description of studies
The search strategy run on 23 November 2007 identified 1851 abstracts (1021 excluding duplicates), of which we obtained 23 references in full as potentially meeting the inclusion criteria. On review of the full papers, we identified no studies that met the inclusion criteria. We identified a further 140 abstracts when the search was updated on 16 June 2009 and we identified 48 abstracts when the search was further updated on 2 December 2009.
From assessment of these additional abstracts, none met the inclusion criteria.
The updated searches carried out in November 2013 identified 304 abstracts (261 excluding duplicates), of which we obtained 18 references in full as potentially meeting the inclusion criteria. On review of the full papers, we identified no studies that met the inclusion criteria, therefore there were no studies included in the review.
We found no registered trials of droperidol for the management of nausea or vomiting in palliative care. The study flow diagram is shown in Figure 1.
1.
Study flow diagram.
We excluded 41 studies (23 from the 2010 review and 18 from the updated 2013 search) and these are detailed in the Characteristics of excluded studies table.
Risk of bias in included studies
We included no studies.
Effects of interventions
It was not possible to draw conclusions about the effects of droperidol in the palliative care setting as we could find no included studies for this review.
Discussion
Evidence for the effectiveness of droperidol
Droperidol has been widely used as an antiemetic, particularly for the prophylaxis and treatment of postoperative nausea and vomiting (PONV), and it has been studied for the prophylaxis of nausea and vomiting associated with chemotherapy (e.g. cisplatin).
Droperidol for postoperative nausea and vomiting has been systematically reviewed (Carlisle 2006), and there is some evidence for its effectiveness in this context. Carlisle's systematic review identified 222 studies examining the effectiveness of droperidol for PONV. The relative risk (compared to placebo) was 0.65 for nausea and 0.65 for vomiting. A systematic review of antiemetics for the control of PONV for patients receiving patient‐controlled analgesia found that droperidol was significantly more effective than placebo (Tramer 1999), with numbers needed to treat of 2.7 for nausea (confidence interval 1.8 to 5.2) and 3.1 for vomiting (confidence interval 2.3 to 4.8), compared to placebo.
Of the studies reporting the effectiveness of droperidol for the prevention of nausea and vomiting associated with chemotherapy (Aapro 1991; Fujii 1987; Herrstedt 1991; Jacobs 1980; Kim 1994; Lehoczky 2001; Lennox 1985; Lewis 1984; Melsom 1982; Minegishi 2003; Muller 1989; Niijima 1986; Owens 1984; Poka 1993; Roberts 1985; Sagae 2003; Saller 1986; Stuart‐Harris 1983), one included only participants in the palliative stage of their illness. This was a cross‐over study of 32 in‐patients with advanced lung cancer receiving cisplatin chemotherapy (Fujii 1987). The addition of droperidol to dexamethasone and metoclopramide was reported to be associated with a shorter median duration of nausea (two days versus four days, P value < 0.05), but no significant difference in median vomiting duration or volume. However, randomisation, allocation concealment and blinding methods were not clear.
The use of droperidol as an antiemetic has also been studied in patients with severe non‐malignant low back pain who were treated with an epidural catheter (Aldrete 1995), and in patients attending the emergency department who received treatment of nausea or vomiting due to any cause (Braude 2006; Patanwala 2010).
It is not clear to what extent these studies can be extrapolated to the palliative care setting and other causes of nausea and vomiting.
Side effects
In 2001, the United States Food and Drug Administration issued a black box warning against the use of droperidol, in view of case reports of prolongation of the QT interval, and cardiac arrhythmia and sudden death (Food and Drug Administration 2001).
This has been an area of controversy, with several authors subsequently defending the use of droperidol (McKeage 2006; Nuttall 2007). A full review of the relevant literature is beyond the scope of this systematic review.
Other side effects reported in the literature (in the context of postoperative nausea and vomiting and chemotherapy‐associated nausea and vomiting) include drowsiness or sedation, akathisia, dystonia, anxiety or restlessness, euphoria, hypotension, flush, dry mouth or rigor (Aapro 1991; Braude 2006; Jacobs 1980; Roberts 1985; Sagae 2003; Saller 1986). Since droperidol is often given with other medication in these settings it can be difficult to establish causality. Sedation appears to be the most commonly reported side effect.
Droperidol in palliative care
Despite previous widespread use and research in anaesthesia and oncology, we did not find any published evidence from randomised controlled trials of the use of droperidol in palliative care settings. A letter by Thangathurai asserts the usefulness of droperidol for the palliation of nausea and vomiting (Thangathurai 2010). Haloperidol (like droperidol, a butyrophenone) is more commonly used in palliative care within the UK and its use for the management of nausea and vomiting in palliative care has been systematically reviewed separately (Perkins 2009).
Studies of antiemetics in palliative care settings are needed to identify which agents are most effective, with minimum side effects (Davis 2010).
Systematic reviews and the evidence base in palliative care
Previous systematic reviews in palliative care have been beset by the problem of the lack of evidence from original studies, particularly randomised controlled trials. Cochrane systematic reviews in palliative care published up to December 2007 were reviewed by Wee 2008, who concluded that "Cochrane reviews in palliative care ... fail to provide good evidence for clinical practice because the primary studies are few in number, small, clinically heterogeneous, and of poor quality and external validity". It can be difficult to carry out randomised controlled trials in palliative care (Grande 2000), and other methodological approaches may be useful in this context. However, Hadley et al note that good quality observational studies are also sparse (Hadley 2009).
Authors' conclusions
Implications for practice.
Since first publication of this review, no new studies were found. There is insufficient evidence from randomised controlled trials at present to advise on the use of droperidol for the management of nausea and vomiting in palliative care.
Implications for research.
Studies of antiemetics in palliative care settings are needed to identify which agents are most effective, with minimum side effects.
What's new
| Date | Event | Description |
|---|---|---|
| 26 May 2020 | Review declared as stable | See Published notes. |
History
Protocol first published: Issue 1, 2008 Review first published: Issue 10, 2010
| Date | Event | Description |
|---|---|---|
| 26 November 2014 | Review declared as stable | This review will be assessed for further updating in 2020 as it is unlikely that new evidence will be published. |
| 19 November 2013 | New citation required but conclusions have not changed | No additional studies were identified for inclusion in this update, and the conclusions remain unchanged. |
| 19 November 2013 | New search has been performed | This review has been updated to include the results of a new search. Change of authorship. |
| 12 November 2008 | Amended | Contact details updated. |
| 5 August 2008 | Amended | Converted to new review format. |
Notes
In May 2020, we performed a restricted updated search on MEDLINE, and also searched trial registries for relevant ongoing studies. We did not identify any potentially relevant studies for inclusion. The authors acknowledge that the number of publications on this topic has been steadily decreasing since 2002, and that most new publications relate to a postoperative setting rather than palliative care. Therefore, this review has now been stabilised following discussion between the authors and editors. If appropriate, we will update the review if new evidence likely to change the conclusions is published, or if standards change substantially which necessitate major revisions.
Acknowledgements
For the 2010 review we would like to thank the staff of the Cochrane Pain, Palliative & Supportive Care Review Group, including Jessica Thomas, Yvonne Roy, Anna Hobson, Sylvia Bickley for help with refining the search strategy, Caroline Struthers for updating the search, Mari Imamura for translation of two Japanese papers, and our peer referees, Giovambattista Zeppetella and Janet Wale, who commented on the draft of the protocol for this systematic review, and Karl Gallegos, Gerhild Becker and Andrew Moore who commented on the review. Thanks also to Linda Porter and Lyn Jackson (pharmacists) and Susan Merner (librarian) at Poole Hospital NHS Foundation Trust.
For the updated 2013 review we would like to thank Jo Abbott (Trials Search Co‐ordinator), Jane Hayes, Yvonne Roy, Mike Bennett and Phil Wiffen at The Cochrane Collaboration. We would also like to thank the librarians at the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, University Hospital Southampton NHS Foundation Trust and Barbara Peirce at Poole Hospital NHS Foundation Trust.
Cochrane Review Group funding acknowledgement: The National Institute for Health Research (NIHR) is the largest single funder of the Cochrane PaPaS Group. Disclaimer: The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR, National Health Service (NHS) or the Department of Health.
Appendices
Appendix 1. MEDLINE search strategy
1. RANDOMIZED CONTROLLED TRIAL.pt. 2. CONTROLLED CLINICAL TRIAL.pt. 3. RANDOMIZED CONTROLLED TRIALS.sh. 4. RANDOM ALLOCATION.sh. 5. DOUBLE BLIND METHOD.sh. 6. SINGLE BLIND METHOD.sh. 7. 1 or 2 or 3 or 4 or 5 or 6 8. (ANIMALS not HUMAN).sh. 9. 7 not 8 10. CLINICAL TRIAL.pt. 11. exp CLINICAL TRIALS/ 12. (clin$ adj25 trial$).ti,ab. 13. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).ti,ab. 14. PLACEBOS.sh. 15. placebo$.ti,ab. 16. random$.ti,ab. 17. RESEARCH DESIGN.sh. 18. 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 19. 18 not 8 20. 19 not 9 21. COMPARATIVE STUDY.sh. 22. exp EVALUATION STUDIES/ 23. FOLLOW UP STUDIES.sh. 24. PROSPECTIVE STUDIES.sh. 25. (control$ or prospectiv$ or volunteer$).ti,ab. 26. 21 or 22 or 23 or 24 or 25 27. 26 not 8 28. 27 not (9 or 20) 29. 9 or 20 or 28 30. nause$.mp. 31. vomit$.mp. 32. emesis.mp. 33. emet$.mp. 34. anti‐eme$.mp. 35. antieme$.mp. 36. antiemetics.sh. 37. nausea.sh. 38. vomiting.sh. 39. 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 40. droperidol.mp. 41. droleptan$.mp. 42. dehydrobenzperidol$.mp. 43. droperdal$.mp. 44. inapsine$.mp. 45. droperol$.mp. 46. sintodian$.mp. 47. dridol$.mp. 48. inapsin$.mp. 49. paxical$.mp. 50. dehidrobenzperidol$.mp. 51. 40 or 41 or 42 or 43 or 44 or 45 or 46 or 47 or 48 or 49 or 50 52. butyrophenone$.mp. 53. exp butyrophenones/ 54. 52 or 53 55. 51 or 54 56. 29 and 39 and 55
Characteristics of studies
Characteristics of excluded studies [ordered by study ID]
| Study | Reason for exclusion |
|---|---|
| Aapro 1991 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Underlying diagnoses not clear. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Aldrete 1995 | Population not restricted to adults suffering from an incurable progressive medical condition |
| Braude 2006 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Any diagnosis causing nausea or vomiting |
| Casey 2011 | Not a RCT; not specific to droperidol |
| Cheung 2011 | Not specific to droperidol |
| Dale 2011 | Not a RCT; not specific to droperidol |
| Etievant 2010 | Not specific to droperidol, nausea or vomiting |
| Feyer 2011 | Prophylaxis and treatment of chemotherapy‐induced nausea and vomiting |
| Fujii 1987 | Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Getto 2011 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition |
| Glare 2011 | Not specific to droperidol |
| Gonzales 2011 | Not specific to droperidol |
| Hardy 2010 | Not specific to droperidol |
| Herrstedt 1991 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Jacobs 1980 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition (stage of cancers not documented). Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Kim 1994 | Prophylaxis of interleukin‐associated nausea and vomiting |
| Lehoczky 2001 | Not randomised. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Lennox 1985 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting. Abstract only |
| Lewis 1984 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| McHugh 2011 | Not specific to droperidol |
| McNicol 2003 | Systematic review rather than randomised controlled trial. Not specific to droperidol, nausea or vomiting |
| Melsom 1982 | Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Minegishi 2003 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition (stage of cancers not documented). Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Muller 1989 | Inadequate detail to assess population (abstract only), but not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Niijima 1986 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| O'Connor 2011 | Not specific to droperidol |
| Owens 1984 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Patanwala 2010 | Not randomised. Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition |
| Poka 1993 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Richards 2011 | Not specific to droperidol, nausea or vomiting |
| Roberts 1985 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Sagae 2003 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Saller 1986 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Smith 2010 | Not specific to droperidol |
| Smith 2011 | Not specific to droperidol |
| Smith 2012 | Not specific to droperidol |
| Stuart‐Harris 1983 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Thangathurai 2010 | Not a RCT |
| Tramer 1999 | Population not restricted to adults receiving palliative care or suffering from an incurable progressive medical condition. Prophylaxis of postoperative nausea and vomiting |
| White 1992 | Not a RCT ‐ groups treated sequentially. Prophylaxis of chemotherapy‐associated nausea and vomiting |
| Yang 2011 | Not specific to droperidol, nausea or vomiting |
RCT: randomised controlled trial
Differences between protocol and review
We excluded studies of antiemetics used for the prophylaxis of nausea or vomiting associated with chemotherapy.
Contributions of authors
SD and Paul Perkins designed the original systematic review. SD and Sylvia Bickley developed the search strategy with comments from PP. SD and PP independently reviewed all titles and abstracts yielded by the search strategy (2010) and discussed any discrepancies to achieve a consensus. JS, MH and TP independently reviewed all abstracts yielded by the updated searches (2013); full papers were reviewed independently by JS, MH, TP and SD. JS, MH and TP updated the text of the review which SD wrote in 2010 with input from PP. SD is the corresponding author and contact for future updates.
Sources of support
Internal sources
-
Poole Hospital NHS Foundation Trust, UK
Library services
-
Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, UK
Library Services
-
Southampton University Hospital Trust, UK
Library Services
External sources
-
The Cochrane Collaboration, UK
Searches and editorial review
Declarations of interest
JS: None known.
MH: None known.
TP: None known.
SD: None known.
Stable (no update expected for reasons given in 'What's new')
References
References to studies excluded from this review
Aapro 1991 {published data only}
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