Glycopyrronium Bromide versus Droperidol for Prophylaxis of Postoperative Nausea and Vomiting in Hysteroscopic Day Surgery: A Randomized, Double-Blind, Non-Inferiority Trial.

PURPOSE: To investigate the efficacy of glycopyrronium bromide in preventing postoperative nausea and vomiting (PONV) in patients undergoing gynecological hysteroscopic day surgery.

PATIENTS AND

METHODS

This study is a prospective, randomized, double-blind, non-inferiority trial. The non-inferiority margin was set at 15%. Patients scheduled for elective gynecological hysteroscopic day surgery under general anesthesia from November 2025 to February 2026 were selected. A total of 260 eligible patients were randomly assigned to receive glycopyrronium bromide (Group G) or droperidol (Group F). Patients in Group G received intravenous glycopyrronium bromide 0.2 mg, while those in Group F received intravenous droperidol 1 mg. Surgery was performed under general anesthesia with remimazolam combined with alfentanil. The primary outcome observed was the incidence of PONV within 24 hours after surgery in both groups.

RESULTS

Within 24 hours postoperatively, the incidence of nausea and vomiting in Group G was non-inferior to that in Group F (37.1% vs 34.1%, risk difference 3.0%; 95% confidence interval -9.0 to 14.7; upper limit < non-inferiority margin of 15%). In the PACU, the incidence of nausea and vomiting in Group G and Group F was 22.6% vs 17.9%, respectively (risk difference 4.7%; 95% confidence interval -5.4 to 14.6). Regarding perioperative adverse reactions, there was no statistically significant difference in the incidence of hypotension between the two groups(30.6% vs 39.8%, P=0.130). The incidence of bradycardia was higher in Group F than in Group G (7.3% vs 1.6%, P=0.030). Furthermore, the incidence of parched mouth was higher in Group G than in Group F (67.7% vs 15.4%, P=0.001).

CONCLUSION

This study found that glycopyrronium bromide is non-inferior to droperidol in preventing PONV within 24 hours after gynecological hysteroscopic day surgery.