Aprepitant prophylaxis effectively reduces preventing postoperative nausea and vomiting in patients receiving opioid based intravenous patient-controlled analgesia
Anesthesia and Pain Medicine
;
: 256-263, 2018.
Article
in English
| WPRIM
| ID: wpr-715760
ABSTRACT
BACKGROUND:
Aprepitant is effective in prevention of chemotherapy-induced nausea and vomiting, when administrated with other antiemetics. We compared the effectiveness of aprepitant to ondansetron for prevention of post-operative nausea and vomiting (PONV) in patients who received a patient-controlled analgesia (PCA) containing opioids.METHODS:
198 patients were randomized into two groups. The treatment group was received an aprepitant, 80 mg, and the control group received a placebo. General anesthesia with inhalational anesthetics–N2O was performed, and PCA was supplied, which contained opioids-NSAIDs-ondansetron. The primary end-point was the incidence of PONV for postoperative 48 hours, and the secondary end-point was the changes in the relationship between PONV incidence and risk factors.RESULTS:
PONV incidence in the treatment group was lower than in the control group (18.6% [95% CI 10.8–26.3], 33.3% [95% CI 23.6–43.1], respectively, P = 0.021). Relative risk of PONV in the control group was 1.80 (95% CI 1.08–3.00, P = 0.010). PONV scores peaked at around postoperative 6 hours, then gradually decreased in the control group but not in the treatment group, which showed lower values than the control group (P = 0.001), and no changing patterns were observed (P < 0.001). Risk factors analyzed were sex, surgery type, history of motion sickness or PONV, and smoking habits. Their effects of all risk factors except sex were abolished in the treatment group.CONCLUSIONS:
Prophylactic aprepitant with ondansetron was more effective than ondansetron-only regimen in preventing PONV after volatile anesthesia with opioid-containing PCA. Aprepitant abolished the effects of most of risk factors, so it could be efficacious in a high-risk PONV group.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Smoke
/
Vomiting
/
Passive Cutaneous Anaphylaxis
/
Smoking
/
Motion Sickness
/
Incidence
/
Risk Factors
/
Analgesia, Patient-Controlled
/
Ondansetron
/
Postoperative Nausea and Vomiting
Type of study:
Controlled clinical trial
/
Etiology study
/
Incidence study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Anesthesia and Pain Medicine
Year:
2018
Type:
Article
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