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.