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Droperidol was used widely in emergency departments until 2001, when an FDA black box warning about possible torsades de pointes (TdP) severely limited its use. Since then, controversy has raged regarding whether the FDA action was justified, and other antinauseants, including ondansetron, have been shown to cause similar QT prolongation (Journal Watch Emergency Medicine Jun 28 2005). However, the FDA has stood fast.
Investigators from Mayo Clinic retrospectively reviewed records for patients who had surgery during the 3 years immediately before (139,932 patients) and after (151,526 patients) the black box warning to identify those who died or developed QT prolongation or TdP within 48 hours after surgery. A separate analysis of 150 randomly…