Use of Aprepitant (80 mg) for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Abstract

Introduction Postoperative nausea and vomiting (PONV) is a complication after surgery, and more significantly after bariatric surgery (up to 79%) leading to increased treatment costs associated with prolonged hospital stays. In a community hospital setting, a standard prophylactic regimen was compared with the addition of aprepitant. Methods A retrospective chart review of PONV among patients who underwent laparoscopic sleeve gastrectomy. Primary outcomes: efficacy of aprepitant 80 mg plus standard prophylaxis on PONV by measuring the number of antiemetics administered postoperatively to a standard prophylactic regimen. Results A total of 354 patients showed that the aprepitant group required significantly fewer doses in four time periods: within 1 hour of post-anesthesia care unit (PACU) admission [74 vs 97 (p = 0.049)], 12 hours [192 vs 234 (p = 0.049)], 24 hours [293 vs 426 (p < 0.001)], and total doses during admission 365 vs 581 (p < 0.001). Average length of stay (LOS) was 1.19 days for the aprepitant group and 1.33 days for the control group (p < 0.001). Conclusion Aprepitant significantly reduced antiemetic use postoperatively and should be considered in addition to a standard PONV prophylaxis regimen to prevent PONV in patients undergoing laparoscopic sleeve gastrectomy and to potentially reduce LOS.