Contributor: Aaron Lessen MD

Educational Pearls:

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.
Overall, droperidol and ondansetron had similar primary outcomes in acute nausea control

Symptom improvement in 93% of patients receiving droperidol vs. 87% receiving ondansetron (P = 0.362)

Secondary measures were, however, statistically significantly different between groups

Patients needed fewer rescue/additional antiemetics in the droperidol group (16%) compared with the ondansetron group (37%); p = 0.016
Similarly, more patients in the droperidol group reported they achieved the desired effect of the medication (85% vs. 63%; p = 0.006)

Patients receiving droperidol did experience increased drowsiness

40% in the droperidol group vs. 11% in the ondansetron group

The trial did not assess the length of stay in the ED after administering medications, which is a potential avenue for future research.

References

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:10.1111/1742-6723.14174

Summarized & Edited by Jorge Chalit, OMSII

Podcast 865: Nausea Treatments - Droperidol vs Ondansetron RCT

Emergency Medical Minute