The online version of this article (doi:10.1186/1471-2253-14-68) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
HYM was the primary individual who wrote the manuscript and performed the data analysis as the first author. CWB was the primary investigator; designed and conducted the study, performed the data analysis, and prepared the manuscript. GJC assisted in the preparation and translation of the manuscript. HYS was responsible for grouping the patients in the study and the preparation of the study medication. The author also assisted in the manuscript preparation. HK helped design and analyse the statistical study and assisted in the manuscript preparation. YHJ administered general anaesthesia to the study patients. YCW was the clinical advisor for the research study and manuscript preparation. JYK was the clinical advisor for the decision support rules, research study, and manuscript preparation. SGP explained the study design to the patients and collected the data. All authors read and approved the final manuscript.
Postoperative nausea and vomiting (PONV) is one of the most common postsurgical complications. Palonosetron, a 5-hydroxytryptamine receptor antagonist, is effective for PONV prevention. Herein, we compared palonosetron and aprepitant (a neurokinin-1 receptor antagonist) for PONV prevention in patients indicated for laparoscopic gynaecologic surgery.
Ninety-three patients who were scheduled to undergo laparoscopic gynaecologic surgery under general anaesthesia were assigned to receive either a single intravenous injection of 0.075-mg palonosetron or 40-mg oral aprepitant in a double-blind randomised trial. The primary efficacy end points included complete response (visual analogue scale [VAS] nausea score <4 and no use of rescue therapy) 0–48 h after surgery. Nausea severity (0–10) and use of rescue therapy were monitored for 0–48 h. The secondary efficacy end points were the effect of aprepitant quantified using a 10-point VAS for pain, consumption of intravenous patient-controlled analgesia, and use of rescue analgesics.
Aprepitant was non-inferior to palonosetron in terms of complete response 0–48 hours after surgery (74% vs. 77%). At 0 and 2 h after administration, the nausea severity with 40-mg aprepitant was significantly lesser than that with 0.075-mg palonosetron (P < 0.05). At 6 and 24 h after administration, fentanyl consumption with 40-mg aprepitant was significantly lower than that with 0.075-mg palonosetron. Greater amounts of rescue analgesics were required in the aprepitant group.
Palonosetron and aprepitant were both effective for PONV prevention in the patients indicated for laparoscopic gynaecologic surgery. The drugs can be used in combination for multimodal therapy because they bind to different receptors. More research is needed to evaluate the effects of aprepitant on pain management in humans.
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- Palonosetron and aprepitant for the prevention of postoperative nausea and vomiting in patients indicated for laparoscopic gynaecologic surgery: a double-blind randomised trial
Hyoung Yong Moon
Chong Wha Baek
Geun Joo Choi
Hwa Yong Shin
Yong Hun Jung
Young Cheol Woo
Jin Yun Kim
Seul Gi Park
- BioMed Central
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