Droperidol


Droperidol is a neuroleptic drug (butyrophenone class) frequently used postoperatively as an antiemetic and a sedative.
 
Incidence
Exceptional.
 
Risk factors
Phenothiazine hypersensitivity.
 
Clinical manifestations
General: anaphylactic shock.
 
Cutaneous: angioedema (swollen tongue), erythema of face and torso.
 
Respiratory: bronchospasm.
 
Diagnostic methods
Cutaneous testing
 
Intradermal skin-tests (1/1000) positive in 2 patients.
 
Mechanisms
IgE-mediated hypersensitivity (positive cutaneous tests, one case with positive Prausnitz-Kustner test).
 
Increase in serum histamine due to inhibition of histamine-N-methyltransferase.
 
Management
Avoidance.
 

References

  1. Palombaro J.F, Klingelberger C.E, "Angioedema associated with droperidol administration", Ann. Emerg. Med., 1996 ; 27 (3): 379-81
  2. Corke P.J, Murray G, "Angio-oedema with droperidol", Anaesth. Intensive. Care., 1993 ; 21 (3): 375
  3. Clark R.J, "Tongue-swelling with droperidol", Anaesth. Intesive. Care., 1993 ; 21 (6): 898
  4. Moss J, Verburg K.M, Henry D.P, "Droperidol inhibits histamine N-methyl transferase", Anesthesiology, 1985 ; 63: A303.
  5. Occelli G, Saban Y, Pruneta R.M, Pourcher N, Michel A.M, Maestracci P, "Deux cas d’anaphylaxie au droperidol", Ann. Fr. Anesth. Reanim, 1984 ; 3 (6): 440-2

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.