Droperidol is administered intravenously and was developed originally for use in neuroleptic anaesthetic regimens. This technique, which involved the combination of high-dose opioids and droperidol with no volatile agent, has now been abandoned because of concerns regarding awareness. The redistribution halflife of droperidol is approximately 10 min and elimination half-life 2 h (Table 21.6).
Many studies have confirmed the efficacy of droperidol against placebo, but sedation is often reported. Side-effects are similar to those of the phenothiazines. Extrapyramidal reactions are less frequent compared with metoclopramide. Feelings of apprehension, restlessness and even nightmares are less obvious but occur more frequently. In addition to antagonistic effects at the dopamine receptor, droperidol is also an a-adrenergic antagonist and may cause vasodilatation and hypotension. It has been recently withdrawn from use in the UK.
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