Aprepitant plus Ondansetron Compared with Ondansetron Alone in Reducing Postoperative Nausea and Vomiting in Ambulatory Patients Undergoing Plastic Surgery

Abstract

Therapeutic, II.

The effects of intravenous fosaprepitant and ondansetron in the prevention of postoperative nausea and vomiting in patients who underwent lower limb surgery: a prospective, randomized, double-blind study

“…Aprepitant has already proved to be effective in the prevention of PONV in some studies [16][17][18]. We previously reported that orally administered aprepitant was also effective in decreasing the incidence of PONV after laparoscopic gynecological surgery [19].…”

“…Gan et al [21] also determined that aprepitant and ondansetron had similar preventive effects on postoperative nausea, but aprepitant was more effective in the prevention of vomiting than ondansetron in a study comparing the two drugs. Recently, Vallejo et al [18] reported that the addition of aprepitant to ondansetron significantly decreased postoperative vomiting rates and nausea severity for up to 48 h after plastic surgery. These results suggest that aprepitant prevents PONV by decreasing the vomiting rate and is not adequate for the complete prevention of postoperative nausea.…”

Aprepitant: A New Modality for the Prevention of Postoperative Nausea and Vomiting: An Evidence-Based Review

“…1 Patient-specific risk factors include female gender, nonsmoking status, and a history of PONV and/or motion sickness. 2,4,5 Anesthetic considerations include use of volatile agents, nitrous oxide, and postoperative opioids. 2,6 Surgery-related elements, such as the duration and type of surgery, are also of special concern (Table 1).…”

“…1,4 Unfortunately, common antiemetics used today tend to have a limited duration of action, variable reliability, and may reduce overall incidence of PONV by only 26%. 5,9 For this reason, there is a need to develop and use medications that act at a different receptor, have a prolonged effect, and have minimal adverse side effects in prevention of PONV.…”

“…[2][3][4][5]7 NK1 receptors exist peripherally and centrally and combine themselves with substance P. Substance P is an endogenous ligand for NK1 receptors and plays a significant role in the vomiting center. 4,9 The combination of substance P and NK1 receptors produces a reaction in the vomiting center in the brain and gastrointestinal tract.…”