PMID- 34125037
OWN - NLM
STAT- MEDLINE
DCOM- 20210702
LR  - 20210702
IS  - 1936-9018 (Electronic)
IS  - 1936-900X (Print)
IS  - 1936-900X (Linking)
VI  - 22
IP  - 3
DP  - 2021 May 5
TI  - Study of Haloperidol for Abdominal Pain in the Emergency Department (SHAPE).
PG  - 623-627
LID - 10.5811/westjem.2021.2.50390 [doi]
AB  - INTRODUCTION: Intravenous haloperidol has been shown to decrease milligram 
      morphine equivalents (MME) of analgesia and reduce hospital admissions for 
      diabetic gastroparesis. The objective of this study was to evaluate whether 
      haloperidol decreases MME for the treatment of non-specific abdominal pain 
      diagnoses in the emergency department (ED), including gastroparesis, cyclic 
      vomiting, cannabinoid hyperemesis syndrome, and unspecified abdominal pain. The 
      primary outcome compared the difference in MME between encounters. Secondary 
      outcomes included admission rate, pain scores, length of stay, rescue therapy 
      administration, and adverse effects. METHODS: This retrospective chart review 
      included patients >/= 18 years old who presented to the ED. Patients must have had 
      >/= 2 ED encounters for abdominal pain, one in which they received conventional 
      therapy with opioids (C-encounter), and the other in which they received 
      haloperidol (H-encounter). Agitated patients were excluded. Seventy-five patients 
      were needed to detect a 3 MME difference with 80% power and two-sided alpha of 
      0.05. RESULTS: We analyzed 107 patients with self-matched encounters. The median 
      dose of haloperidol administered was 5.0 milligrams (mg) (interquartile range 
      [IQR] 2.0 - 5.0). C-encounters had significantly more MME administered than 
      H-encounters (median 5.7 mg [IQR 4.0 - 8.0] vs 0.0 mg [IQR 0.0 - 2.5], P < 
      0.001). These results remained significant despite route of haloperidol 
      administration. C-encounters had higher rates of rescue therapy administration 
      than H-encounters, (56% vs 33.6%, P < 0.001). There were higher rates of 
      ketorolac administration in the H-encounter (P = 0.02). CONCLUSION: Encounters in 
      which patients received haloperidol and ketorolac for abdominal pain had a 
      statistically significant reduction in MME administered and lower rates of rescue 
      therapy administration than encounters in which patients were treated with 
      opioids.
FAU - Knudsen-Lachendro, Katherine
AU  - Knudsen-Lachendro K
AD  - Cleveland Clinic Lutheran Hospital, Department of Pharmacy, Cleveland, Ohio.
FAU - Stith, Kyle
AU  - Stith K
AD  - Cleveland Clinic Medina Hospital, Department of Pharmacy, Medina, Ohio.
FAU - Vicarel, Laine A
AU  - Vicarel LA
AD  - Cleveland Clinic Medina Hospital, Department of Pharmacy, Medina, Ohio.
FAU - Harbert, Brittany
AU  - Harbert B
AD  - Aultman Hospital, Department of Pharmacy, Canton, Ohio.
FAU - Fertel, Baruch S
AU  - Fertel BS
AD  - Cleveland Clinic Enterprise Services Institute, Enterprise Quality and Safety, 
      Cleveland, Ohio.
LA  - eng
PT  - Journal Article
DEP - 20210505
PL  - United States
TA  - West J Emerg Med
JT  - The western journal of emergency medicine
JID - 101476450
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Antiemetics)
RN  - J6292F8L3D (Haloperidol)
SB  - IM
MH  - Abdominal Pain/*drug therapy
MH  - Adolescent
MH  - Adult
MH  - Analgesics, Opioid/therapeutic use
MH  - Antiemetics/*administration & dosage
MH  - Cross-Over Studies
MH  - Emergency Service, Hospital
MH  - Haloperidol/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Management/methods
MH  - Retrospective Studies
PMC - PMC8202980
COIS- Conflicts of Interest: By the WestJEM article submission agreement, all authors 
      are required to disclose all affiliations, funding sources and financial or 
      management relationships that could be perceived as potential sources of bias. No 
      author has professional or financial relationships with any companies that are 
      relevant to this study. There are no conflicts of interest or sources of funding 
      to declare.
EDAT- 2021/06/15 06:00
MHDA- 2021/07/03 06:00
PMCR- 2021/05/01
CRDT- 2021/06/14 12:25
PHST- 2020/10/21 00:00 [received]
PHST- 2021/02/09 00:00 [accepted]
PHST- 2021/06/14 12:25 [entrez]
PHST- 2021/06/15 06:00 [pubmed]
PHST- 2021/07/03 06:00 [medline]
PHST- 2021/05/01 00:00 [pmc-release]
AID - westjem.2021.2.50390 [pii]
AID - wjem-22-623 [pii]
AID - 10.5811/westjem.2021.2.50390 [doi]
PST - epublish
SO  - West J Emerg Med. 2021 May 5;22(3):623-627. doi: 10.5811/westjem.2021.2.50390.