High dose droperidol (10-40 mg) was associated with abnormal QT measurements in 4 of 46 patients (8.7%), though this was likely due to pre-existing conditions or other drugs.
Observational (n=46)
Does high dose droperidol cause QT prolongation in patients presenting to the emergency department with aggression?
High dose droperidol was associated with QT prolongation in a small number of patients, but this was more likely due to pre-existing conditions or other drugs rather than droperidol itself.
AIMS: To investigate the QT interval after high dose droperidol using continuous 12-lead Holter recordings. METHODS: This was a prospective study of patients given droperidol with a continuous Holter recording. Patients were recruited from the DORM II study which included patients with aggression presenting to the emergency department. Patients initially received 10 mg droperidol as part of a standardized sedation protocol. An additional 10 mg dose was given after 15 min if required and further doses at the clinical toxicologist's discretion. Continuous 12-lead Holter recordings were obtained for 2-24 h utilizing high resolution digital recordings with automated QT interval measurement. Electrocardiograms were extracted hourly from Holter recordings. The QT interval was plotted against heart rate (HR) on the QT nomogram to determine if it was abnormal. QTc F (Fridericia's HR correction) was calculated and >500 ms was defined as abnormal. RESULTS: Forty-six patients had Holter recordings after 10-40 mg droperidol and 316 QT-HR pairs were included. There were 32 abnormal QT measurements in four patients, three given 10 mg and one 20 mg. In three of the four patients QTc F >500 ms but only in one taking methadone was the timing of QTc F >500 ms consistent with droperidol dosing. Of the three other patients, one took amphetamines, one still had QT prolongation 24 h after droperidol and one took a lamotrigine overdose. No patient given >30 mg had a prolonged QT. There were no arrhythmias. CONCLUSION: QT prolongation was observed with high dose droperidol. However, there was little evidence supporting droperidol being the cause and QT prolongation was more likely due to pre-existing conditions or other drugs.
Calver et al. (Wed,) conducted a observational in Aggression (n=46). High dose droperidol was evaluated on Abnormal QT interval (QTc F >500 ms or abnormal on QT nomogram). High dose droperidol (10-40 mg) was associated with abnormal QT measurements in 4 of 46 patients (8.7%), though this was likely due to pre-existing conditions or other drugs.