The effect of IM Droperidol on driving performance

详细信息    查看全文

• 作者：Jessica Fulton (1)
  Gary Popovetsky (2)
  Jeanne L. Jacoby (2)
  Michael B. Heller (2)
  James Reed (2)
  
• 关键词：droperidol ; butyrophenones ; driving
• 刊名：Journal of Medical Toxicology
• 出版年：2006
• 出版时间：September 2006
• 年：2006
• 卷：2
• 期：3
• 页码：93-96
• 全文大小：118KB
• 参考文献：1. Inapsine (Droperidol Injection), Black Box Warning, Taylor Pharmaceuticals, an Akorn Co, 11/01
  2. McCormick, Cynthia G, MD, US FDA; Current FDA Report on Droperidol Status and Basis for “Black Box-Warning, ACEP News June2002;5&8.
  3. Richman, Peter B., Allega, J, et al. A Randomized Clinical Trial to Assess the Efficacy of Intramuscular Droperidol for the Treatment of Acute Migraine Headache, / The American Journal of Emergency Medicine January2002;Vol 20, No 1, 39-2. CrossRef
  4. Miner, James R., Fish, SJ, et al. Droperidol vs. Prochlorperazine for Benign Headaches in the Emergency Department, / Academic Emergency Medicine, September2001;Vol 8, No 9, 873-79. CrossRef
  5. Wang SJ, et al., Droperidol Treatment for Acute Status Migrainosis and Refractory Migraine. / Headache 1997; 37: pp 377-2. CrossRef
  6. PDR, Droperidol, Medical Economics Data,1992.
  7. Weiler, John M., Bloomfield, JR, et al. Effects of Fexofenadine, Diphenhydramine, and Alcohol on Driving Performance: A Randomized, Placebo-Controlled Trial in the Iowa Driving Simulator., / Annals of Internal Medicine 7 Mar2000;Vol 132, No 5: 354-63.
  8. Gengo, FM, Gabos C, Mechtler L. Quantitative effects of cetirizine and diphenhydramine on mental performance measured using an automobile driving simulator. / Annals of Allergy June1990; 64: 520-.
  9. Witek TJ, Canestrari DA, Miller RD, Yang JY, Riker DK. Characterization of daytime sleepiness and psychomotor performance following H1 receptor antagonists. / Annals of Allergy, Asthma and Immunology 1995;74-419-26.
  10. Todd, KH, Funk KG, Funk JP, Bonacci, R. Clinical Significance of Reported Changes in Pain Severity. / Annals of Emergency Medicine. April1996; 27: 485-89. CrossRef
  
• 作者单位：Jessica Fulton (1)
  Gary Popovetsky (2)
  Jeanne L. Jacoby (2)
  Michael B. Heller (2)
  James Reed (2)
  
  1. NYC Poison Control Center, 455 1st Avenue Room 123, 10016, New York, NY
  2. Emergency Medicine Residency, St. Luke’s Hospital, 801 Ostrum Street, 18015, Bethlehem, PA
  
• ISSN：1937-6995

文摘

Objectives Droperidol (DROP) is used in the emergency department (ED) for several indications, but its effect on psychomotor performance is unclear. The purpose of this study was to evaluate the effects of DROP, 2.5 mg intramuscular (IM), on driving performance. Methods This was a randomized, double-blinded, two-period, placebo-controlled crossover trial that utilized a standard drivertraining program with computerized scoring. We solicited 20 paid volunteers who were pre-screened with a 12-lead EKG to evaluate QT length. For the first driving simulation, subjects were randomly assigned to receive either 2.5 mg of DROP IM or an equal volume of normal saline (NS). At least 72 hours later, the same subjects participated in a second driving simulation. For the second driving simulation, the assignment of DROP, 2.5 mg IM, or normal saline was reversed: (If a subject received DROP, 2.5 mg IM, in the first simulation, the subject received normal saline in the second simulation; conversely, if a subject received normal saline in the first simulation, the subject received DROP, 2.5 mg IM, in the second simulation). Thirty minutes later, participants drove the 20-minute simulation and received an average score based on the errors made in 4 categories: accelerating, braking, steering, and signaling. Post-testing, participants evaluated their degree of drowsiness and driving impairment using a visual analog scale and compared their perception of impairment to that caused by alcohol ingestion. Data were analyzed using analysis-of-variance, Pearson chisquare and Fischer’s exact test with alpha set at p = 0.05. Results Twenty subjects (11 males and 9 females) completed the protocol. The mean age was 30 years with a range of 20 to 46 years, and the mean weight was 80 kg. The mean driving experience was 12 years. Participants who received DROP felt significantly drowsier (38.6 mm +/?9.0) than those receiving NS (13.2 mm +/?9.0), the mean difference was 25.4 mm p = .009. Subjects receiving DROP were also more likely to feel that their driving would be impaired as rated on the VAS (DROP: 34.6 +/?5.2; NS: 3.2 +/?5.2; p = .0005), and DROP subjects reported impairment equivalent to 1- drinks more frequently than those receiving placebo (61% vs. 16.7%, p < .001). These subjective feelings of impairment were confirmed by their driving performance on the simulator. The mean driving score, using the driving simulator, was 68.8% with DROP vs. 73.6% with NS; p = .013. Conclusions Subjects receiving modest doses of IM DROP report increased perceptions of drowsiness, driving impairment, and intoxication; these perceptions are confirmed on objective testing.