Aprepitant for antiemesis after laparoscopic gynaecological surgery

Ham, Sung Yeon; Shim, Yon Hee; Kim, Eun Ho; Son, Min Ji; Park, W. S.; Lee, Jeong Soo

doi:10.1097/eja.0000000000000242

Cited by 26 publications

(44 citation statements)

References 20 publications

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“…dexamethasone 4–5 mg, i.v. droperidol 0.625–1.25 mg, and oral aprepitant 40 mg have been shown to reduce PONV to a greater extent than single therapy with any of the drugs [6, 30–32]. These results are consistent with our study.…”

Section: Discussionsupporting

confidence: 93%

“…Thus, various pharmacologic agents, such as anticholinergics, antihistamines, promethazine, aprepitant, corticosteroids and 5-hydroxytryptamine (5-HT 3 ) receptor antagonists, have been used to prevent and treat PONV in patients undergoing gynecologic laparoscopy [6–9]. However, PONV still occurs and its incidence reaches approximately 40% despite prophylaxis with a 5-HT 3 receptor antagonist in patients with fentanyl-based intravenous (i.v.)…”

Section: Introductionmentioning

confidence: 99%

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Combination of gabapentin and ramosetron for the prevention of postoperative nausea and vomiting after gynecologic laparoscopic surgery: a prospective randomized comparative study

et al. 2017

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BackgroundAs a drug originally introduced for its anticonvulsant effects, gabapentin has been recently shown to be effective in the treatment of nausea and vomiting in various clinical settings. This study compared the antiemetic efficacy of oral gabapentin, intravenous ramosetron and gabapentin plus ramosetron in patients receiving fentanyl-based patient-controlled analgesia after laparoscopic gynecologic surgery.MethodsOne hundred and thirty two patients undergoing laparoscopic gynecologic surgery under general anesthesia were allocated randomly into three groups: group G received 300 mg oral gabapentin 1 h before anesthesia, group R received 0.3 mg intravenous ramosetron at the end of surgery, and group GR received a combination of 300 mg oral gabapentin 1 h before anesthesia and 0.3 mg intravenous ramosetron at the end of surgery. Postoperative nausea, retching, vomiting, rescue antiemetic drug use, pain, rescue analgesic requirements and adverse effects were assessed at 0–2, 2–24 and 24–48 h after surgery. Postoperative nausea and vomiting (PONV) was defined as the presence of nausea, retching or vomiting.ResultsThe incidence of complete response (no PONV and no rescue antiemetics up to 48 h postoperatively) was significantly higher in group GR (26/40, 65%) than group G (16/40, 40%; P = 0.025) and group R (18/44, 41%; P = 0.027), whereas there was no significant difference between group G and group R (P = 0.932). There were no significant between-group differences in the incidence of emetic episodes, use of rescue antiemetics, severe emesis, use of rescue analgesics or any adverse effects. Postoperative pain scores were also similar among groups.ConclusionsThe combination with gabapentin and ramosetron is superior to either drug alone for prevention of PONV after laparoscopic gynecologic surgery.Trial registrationClinicalTrials.gov NCT02617121, registered November 25, 2015.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Combination of gabapentin and ramosetron for the prevention of postoperative nausea and vomiting after gynecologic laparoscopic surgery: a prospective randomized comparative study

et al. 2017

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“…The guidelines for PONV have been updated based on many clinical studies [ 5 , 6 ]. 5-HT 3 receptor antagonists, including ondansetron, are the gold standard antiemetics [ 7 , 8 ], and NK-1 receptor antagonists are also reported to be as effective as 5-HT 3 receptor antagonists [ 9 , 10 ]. However, 5-HT 3 and NK-1 receptor antagonists have not been approved for routine use by the Japanese Ministry of Health, Labor and Welfare as part of the public medical insurance coverage for perioperative antiemetics due to high cost.…”

Section: Resultsmentioning

confidence: 99%

Effect of Goreisan, a traditional Japanese Kampo medicine, on postoperative nausea and vomiting in gynecological patients

2017

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BackgroundGoreisan, a traditional Japanese Kampo medicine, may prevent postoperative nausea and vomiting (PONV). The purpose of this study was to evaluate the effect of Goreisan on PONV in a high-risk population in a randomized, double-blind, placebo-controlled manner.FindingsPatients undergoing gynecological surgery were randomly allocated to the Goreisan and the control groups. General anesthesia was induced with propofol and remifentanil. After endotracheal intubation, anesthesia was maintained with sevoflurane, fentanyl, and remifentanil. Goreisan 7.5 g dissolved in water (Goreisan group) or water (control group) in a volume of 20 ml was administered through a nasogastric tube approximately 1 h before completion of surgery. The primary outcome of this study was the incidence of PONV during the first 2 h after extubation. In the interim analysis, it was apparent that Goreisan has no effect. Therefore, we discontinued recruiting patients and present results based on data from 83 patients. The incidence of PONV during the first 2 h after extubation was 45% in the Goreisan group (n = 40) and 46.5% in the control group (n = 43) (p = 0.89). There was no significant difference in PONV incidence or severity during the first 24 h post-extubation.ConclusionGoreisan has little potency in preventing PONV in high-risk patients.

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“…There have been several large prospective randomized clinical trials investigating the role of NK1R antagonists as antidepressants, with mixed results (29). There is strong evidence accumulating recently from a large number of prospective randomized controlled clinical trials showing efficiency of NK1R inhibitors in postoperative nausea and vomiting in both adults and children for a large variety of different surgeries (30)(31)(32)(33)(34)(35)(36). No NK1R antagonist to date is approved specifically for cancer therapy, and there are currently no ongoing clinical trials that assess their therapeutic potential regarding cancer.…”

Section: Therapeutic Innovations In Neuroblastomamentioning

confidence: 99%

Therapeutic Innovations for Targeting Childhood Neuroblastoma: Implications of the Neurokinin-1 Receptor System

Berger

Schweinitz

2017

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Aprepitant for antiemesis after laparoscopic gynaecological surgery

Abstract: Clinicaltrial.gov identifier: NCT01897337.

Cited by 26 publications

References 20 publications

Combination of gabapentin and ramosetron for the prevention of postoperative nausea and vomiting after gynecologic laparoscopic surgery: a prospective randomized comparative study

Combination of gabapentin and ramosetron for the prevention of postoperative nausea and vomiting after gynecologic laparoscopic surgery: a prospective randomized comparative study

Effect of Goreisan, a traditional Japanese Kampo medicine, on postoperative nausea and vomiting in gynecological patients

Therapeutic Innovations for Targeting Childhood Neuroblastoma: Implications of the Neurokinin-1 Receptor System

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