IntroductionAprepitant (Emend®) is a novel antiemetic agent that works through antagonism of neurokinin-1 (NK-1) receptors. To date, there are limited data regarding its use to prevent postoperative nausea and vomiting (PONV) in children. We retrospectively reviewed our initial 12-months experience with aprepitant after it was made available for perioperative use.MethodsThe anesthetic records of patients who received aprepitant were retrospectively reviewed and demographic, surgical, and medication data retrieved.ResultsThe study cohort included 31 patients (15 male and 16 female) ranging in age from 4 to 27 years (15.7 ± 7.4 years) and in weight from 14.4 to 175.7 kilograms (59.3 ± 30.2 kgs). Most of the patients (30 of 31) received the capsule form and 1 received the liquid. The average dose of aprepitant administered was 0.9 ± 0.6 mg/kg; however, only one patient received dosing expressed as mg/kg, and the majority received a 40 mg capsule. All of the patients in the cohort had either a previous history of PONV or risk factors for PONV. PONV occurred in the PACU in 1 patient and during the first 24 postoperative hours in 3 additional patients. No adverse effects related to aprepitant use were noted.ConclusionAprepitant was easily added to the preoperative regimen for pediatric patients who may require it. Our approach limited overuse and subsequent cost concerns. Future studies with a comparator group and a greater sample size are needed to demonstrate its efficacy, especially in comparison to time-honored agents such as ondansetron. No adverse effects were noted in our limited study cohort.
Background: Aprepitant (Emend ® ), a neurokinin-receptor antagonist, has seen increased use in the treatment of nausea and vomiting in various clinical scenarios. To date, there are limited data regarding its use in the pediatric population. We retrospectively reviewed our experience with aprepitant after its addition to the operating room formulary for prevention of postoperative nausea and vomiting (PONV). Methods:The anesthetic records of patients who received aprepitant were retrospectively reviewed. Demographic, surgical, medication, and efficacy data were retrieved. Results:The study cohort included 144 patients ranging in age from 7 to 17 years and in weight from 24.7 to 208.9 kg. The most common surgical procedures included gastrointestinal surgery, orthopedic surgery, and otolaryngologic procedures. Reasons for the administration of aprepitant included PONV prophylaxis due to risk factors such as type of surgery, duration of surgery, previous history of significant PONV, female gender, and family history of PONV. The majority of the patients (98.6%) received aprepitant in capsule form in a dose of 40 mg (97.9%). Seventeen patients (11.8%) had PONV or received antiemetic agents postoperatively. There were no unplanned admissions related to PONV. No adverse effects related to aprepitant were noted.Conclusions: Aprepitant was effectively introduced to the preoperative regimen as an additional agent for the prevention of PONV. The overall tolerability and efficacy of aprepitant was similar to previous studies, even in a patient population at high risk for PONV.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.