Haloperidol for the treatment of nausea and vomiting in palliative care patients

 

Abstract

Background

Nausea and vomiting are common symptoms of patients with terminal, incurable illnesses and can be distressing.

Objectives

The primary objective of the review was to evaluate the efficacy and adverse events associated with the use of haloperidol for the treatment of nausea and vomiting in palliative care patients.

Search methods

Several electronic databases were searched including CENTRAL, MEDLINE, EMBASE, CINAHL and AMED, using relevant search terms and synonyms. Handsearching complemented electronic searches (using reference lists of included studies, relevant chapters and review articles). There were no language restrictions imposed. Database searching was performed between 2nd and 16th September 2007.

Selection criteria

Studies considered for inclusion were randomised controlled trials (RCTs) of haloperidol for the treatment of nausea or vomiting, or both, in any setting. The studies had to be conducted with adults receiving palliative care or suffering from an incurable progressive medical condition. Studies where nausea or vomiting, or both, thought to be secondary to pregnancy or surgery were excluded.

Data collection and analysis

Records from each of the electronic databases were imported into a bibliographic package and merged into a core database where titles, keywords and abstracts were inspected for relevance. If it was not possible to accept or reject an abstract with certainty, the full text of the article was obtained for further evaluation. The two review authors independently assessed studies in accordance with the inclusion criteria. There were no differences in opinion between authors with regard to assessment of studies.

Main results

No RCTs were identified meeting the inclusion criteria. Twenty-six studies were considered but all were excluded from the review.

Authors' conclusions

We did not identify any RCTs exploring the effectiveness of haloperidol for nausea and vomiting in palliative care patients.

 

Plain language summary

Haloperidol for the treatment of nausea and vomiting in palliative care patients

We did not identify any randomised controlled trials (RCTs) to find out if haloperidol is a useful drug for the treatment of nausea or vomiting in palliative care patients. Nausea and vomiting are common problems for patients with serious life threatening illnesses and haloperidol is a drug which is sometimes prescribed to help treat these symptoms. This drug can be given orally or by injection. There has been some research looking at how this drug works in sickness caused by surgery and when trying to prevent sickness caused by anti-cancer treatments. During a search of the international literature no studies looking at this treatment in seriously ill or terminally ill patients were found. There is not enough evidence to be able to recommend haloperidol for the treatment of nausea and vomiting in adult patients suffering from incurable progressive medical conditions.

 

摘要

背景

以haloperidol治療安寧療護病患之噁心及嘔吐

噁心及嘔吐為罹患末期疾病、無法治癒之病患常見之症狀，其可造成極大痛苦。

目標

本回顧之主要目的係評估針對使用haloperidol治療安寧療護病患之噁心及嘔吐的功效及不良作用。

搜尋策略

使用相關詞彙及同義字搜尋幾個電子資料庫，包括：CENTRAL、MEDLINE、EMBASE、CINAHL以及AMED。人工搜尋補充電子不足之處(使用納入的研究、相關章節、文獻回顧的參考文獻清單)。不限定文章語言種類。搜尋資料庫的時間介於2007年9月2日 – 16日之間。

選擇標準

考慮收錄之研究為在任何狀況下使用haloperidol治療噁心或嘔吐或是兩者的隨機對照試驗(randomised controlled trials；RCTs)。該等研究必須在以接受安寧照護或是罹患無法治癒之進行性疾病的成人進行。茲排除其中因懷孕或手術造成之噁心或嘔吐之研究。

資料收集與分析

將取自各個電子資料庫之記錄匯入編目套裝軟體中，並合併成為核心資料庫，於其中獨立檢驗篇名、關鍵字、及摘要之相關性。如無法確定接受或排除某篇摘要，則取得該文章之全文以進一步評估。由2位回顧作者根據收錄標準獨立評估研究。諸位回顧作者對研究評估方式之意見並無差異。

主要結論

並未辨識出任何符合收錄標準之RCTs。共考慮26項研究，但其皆由此回顧排除。

作者結論

我們並未發現任何針對安寧照護病患研究haloperidol對於噁心及嘔吐之有效性的RCTs。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

我們並未發現任何隨機對照試驗(randomised controlled trials；RCTs)以決定haloperidol是否為可用於治療安寧照護病患之噁心或嘔吐的有用藥物。噁心及嘔吐為患有嚴重致命疾病之病患的常見問題，而haloperidol為有時會用以協助治療此等症狀之藥物。此種藥物可以口服或注射給與。已有一些有關此種藥物如何作用於由手術所造成之噁心嘔吐以及有關嘗試以其預防由抗癌治療所造成之噁心嘔吐的研究。在針對國際文獻所進行之檢索中，並未發現任何針對患有嚴重疾病或末期疾病之病患探究此種治療的研究。並無足夠之證據可建議針對罹患無法治癒之進行性醫學疾病的成人病患使用haloperidol治療噁心或嘔吐。