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The following is a summary of “Rescue Sedation after 5 mg or 10 mg of Droperidol as the Initial Treatment for Acute Agitation in the Emergency Department,” published in the January 2025 issue of Emergency Medicine by Cole et al. 

Droperidol is frequently employed to manage agitation in the emergency department (ED) setting. However, optimal dosing strategies for this indication remain understudied.  

Researchers conducted a retrospective study to compare the effectiveness of 5 mg vs 10 mg initial droperidol doses for managing acute agitation in the ED.  

They reviewed records of adults in the ED who received either 5 mg or 10 mg droperidol as the initial treatment for agitation between 2010 and 2023. The primary outcome measured was the need for additional (rescue) sedation within 1 hour of the initial dose.  

The results showed 11,568 individuals received droperidol as their initial medication (n = 8,603 [74%] via intramuscular route), with 10,293 receiving 5 mg and 1,275 receiving 10 mg. The median age was 39 years (interquartile range 28–50 years), and 8,372 (72%) were male. Rescue sedation within 1 hour was required for 987 individuals (9.6%) in the 5 mg group and 189 (14.8%) in the 10 mg group (difference 5.2%; 95% CI 3.2–7.3%). Additional sedation at any time was administered to 1,776 (17.3%) in the 5 mg group and 318 (24.9%) in the 10 mg group (difference 7.7%; 95% CI 5.2–10.2%). The median length of stay was 471 minutes (interquartile range 347–611 minutes) in the 5 mg group and 487 minutes (interquartile range 364–641 minutes) in the 10 mg group (median difference 24 minutes; 95% CI 11–37 minutes).  

Investigators concluded that individuals treated with 5 mg of droperidol required less rescue sedation compared to those given 10 mg. 

Source: sciencedirect.com/science/article/abs/pii/S0736467924002348