Patient-controlled analgesia with droperidol and H1 antihistamine for prevention of postoperative nausea and vomiting after laparoscopic gynecological surgery: a retrospective cohort study.

PURPOSE: This study investigated the incidence and risk factors for postoperative nausea and vomiting (PONV) in patients receiving intravenous patient-controlled analgesia (IVPCA) with fentanyl, droperidol, and H1 antihistamine (PCA-DH) after laparoscopic gynecological surgery. Previous studies showed differing PONV incidence and risk factors between IVPCA containing droperidol (PCA-D) and that containing H1 antihistamine (PCA-H). This study aims to assess whether the combination alters incidence or risk profiles.

METHODS: We retrospectively analyzed patients who underwent laparoscopic gynecological surgery under general anesthesia and received PCA-DH. Multivariate logistic regression was used to evaluate associations between PONV and patient characteristics, anesthetic factors, and prophylactic antiemetic use.

RESULTS: Among 3832 patients, the incidence of nausea, vomiting, and rescue antiemetic use was 14.6%, 4.0%, and 5.5%, respectively-lower than previously reported rates in PCA-D (36.6%, 17.6%, 17.7%) and PCA-H (26.5%, 8.7%, 11.0%). Additionally, the risk factors for PONV in PCA-DH differed from those identified in PCA-D and PCA-H studies.

CONCLUSION: IVPCA with both droperidol and H1 antihistamine was associated with a reduced incidence of PONV. The findings suggest that this combination may effectively mitigate opioid-related PONV risk, and that risk factors may vary by IVPCA composition.