Two Cases of Extrapyramidal Reactions to Low Dose Epidural Droperidol Administration

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We report two cases of extrapyramidal reactions apparently caused by epidural droperidol. Two patients (18-yr-old man and 20-yr-old woman) were given continuous epidural droperidol with a dose of 2.5mg/day or below to provide a prophylactic antiemetic effect during administration of epidural morphine. Both patients experienced prolonged somnolence acute dystonia and Parkinsonism. The first patient showed the extrapyramidal reactions 51 hours after the inset of epidural droperidol with a total dose of 3.9mg, and the second patient showed the same reactions at 33 hours of administration, with a total 2.9mg. We consider that because they were both young and particularly sensitive to droperidol, even low doses were excessive to them and caused extrapyramidal reactions. We must be careful about prolonged somnolence in the patients receiving droperidol as antiemetic agent because somnolence can be a symptom of overdose and a premonitory sign of severe adverse side effects, such as extrapyramidal reactions.
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