Abstract
Background
Gastroparesis associated nausea, vomiting & abdominal pain (GP N/V/AP) are common
presentations to the emergency department (ED). Treatment is often limited to antiemetic,
prokinetic, opioid, & nonopioid agents. Haloperidol (HP) has been shown to have analgesic
& antiemetic properties. We sought to evaluate HP in the ED as an alternative treatment
of GP N/V/AP.
Methods
Using an electronic medical record, 52 patients who presented to the ED w/GP N/V/AP
secondary to diabetes mellitus and were treated w/HP were identified. Patients who
received HP were compared to themselves w/the most recent previous encounter in which
HP was not administered. ED length of stay (LOS), additional antiemetics/prokinetics
administered, hospital LOS, and morphine equivalent doses of analgesia (ME) from each
visit were recorded. Descriptive statistics, categorical (Chi Square Test or Z-Test
for proportion) and continuous (Wilcoxon Signed Rank Test) comparisons were calculated.
Statistical significance was considered for two tail p-values less than 0.05.
Results
A statistically significant reduction in ME (Median 6.75 [IQR 7.93] v 10.75 [IQR12]:
p = 0.001) and reduced admissions for GP (5/52 v 14/52: p = 0.02) when HP was administered was observed. There were no statistically significant
differences in ED or hospital LOS, and additional antiemetics administered between
encounters in which HP was administered and not administered. No complications were
identified in patients who received HP.
Conclusions
The rate of admission and ME was found to be significantly reduced in patients with
GP secondary to diabetes mellitus who received HP. HP may represent an appropriate,
effective, and safe alternative to traditional analgesia and antiemetic therapy in
the ED management of GP associated N/V/AP.
To read this article in full you will need to make a payment
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D; use, select 'Corporate R&D; Professionals'
Subscribe:
Subscribe to The American Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Factors influencing admission and outcomes in gastroparesis.Neurogastroenterol Motil. 2013; 25 (e294): 389-398
- Emerging drugs for the treatment of gastroparesis.Expert Opin Emerg Drugs. 2014; 19: 261-279
- Haloperidol in the acute treatment of migraine: a randomized, double-blind, placebo-controlled study.Headache. 2006 May; 46: 781-787
- Antipsychotics for acute and chronic pain in adults.Cochrane Database Syst Rev. 2013 Aug 29; 8 (CD004844)https://doi.org/10.1002/14651858.CD004844.pub3
- Haloperidol binding to an opioid receptor site.Biochem Pharmacol. 1975; 24: 1363-1367
- The opiate receptors.Neurochem Res. 1976 Feb; 1: 3-28
- Haloperidol and analgesia: case reports.Mil Med. 1977 Dec; 142: 946-948
- Analgesia and haloperidol: a hypothesis.J Clin Psychiatry. 1979 Jul; 40: 323-326
- Epidural haloperidol enhances epidural morphine analgesia: three case reports.J Opioid Manag. 2008 May–Jun; 4: 163-166
- Use of very-low-dose methadone and haloperidol for pain control in palliative care patients: are the sigma-1 receptors involved?.J Palliat Med. 2015 Aug; 18: 660
- Haloperidol for treatment of cannabinoid hyperemesis syndrome.Am J Emerg Med. 2013 Jun; 31 (e5-6): 1003
- Is low-dose haloperidol a useful antiemetic?: a meta-analysis of published and unpublished randomized trials.Anesthesiology. 2004 Dec; 101 (PubMed PMID: 15564955): 1454-1463
- Haloperidol vs placebo in addition to conventional therapy to treat pain secondary to gastroparesis in the emergency department. (Abstract).J Pain. 2015 April; 16 (Supplement, S34)
Article Info
Publication History
Published online: March 12, 2017
Accepted:
March 10,
2017
Received in revised form:
March 10,
2017
Received:
January 18,
2017
Footnotes
☆Meetings: An abstract only version of this article was presented at ACEP 2016.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
