title: Efficacy of the oral neurokinin-1 receptor antagonist aprepitant administered with ondansetron for the prevention of postoperative nausea and vomiting.
abstract: BACKGROUND
  5-HT3 receptor antagonist, dexamethasone and droperidol were used for the prevention of postoperative nausea and vomiting (PONV). Recently, neurokinin-1 (NK1) antagonist has been used for PONV. We evaluated the effect of oral aprepitant premedication in addition to ondansetron.
  
  
  METHODS
  A total 90 patients scheduled for elective rhinolaryngological surgery were allocated to three groups (Control, Ap80, Ap125), each of 30 at random. Ondansetron 4 mg was injected intravenously to all patients just before the end of surgery. On the morning of surgery, 80 mg and 125 mg aprepitant were additionally administered into the Ap80 group and Ap125 group, respectively. The rhodes index of nausea, vomiting and retching (RINVR) was checked at 6 hr and 24 hr after surgery.
  
  
  RESULTS
  Twelve patients who used steroids unexpectedly were excluded. Finally 78 patients (control : Ap80 : Ap125 = 24 : 28 : 26) were enrolled. Overall PONV occurrence rate of Ap125 group (1/26, 3.9%) was lower (P = 0.015) than the control group (7/24, 29.2%) at 6 hr after surgery. The nausea distress score of Ap125 group (0.04 ± 0.20) was lower (P = 0.032) than the control group (0.67 ± 1.24) at 6 hr after surgery. No evident side effect of aprepitant was observed.
  
  
  CONCLUSIONS
  Oral aprepitant 125 mg can be used as combination therapy for the prevention of PONV.
authors.affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: Chae Seong
authors.initials: CS
authors.lastname: Lim
authors.forename: Young-Kwon
authors.initials: YK
authors.lastname: Ko
authors.forename: Yoon-Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Park
authors.forename: Jae-Kook
authors.initials: JK
authors.lastname: Kim
authors.forename: Myoung-Joong
authors.initials: MJ
authors.lastname: Kim
authors.forename: Hyun-Joong
authors.initials: HJ
authors.lastname: Kim
keywords: Aprepitant; Ondansetron; PONV
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