The effects of intravenous fosaprepitant and ondansetron in the prevention of postoperative nausea and vomiting in patients who underwent lower limb surgery: a prospective, randomized, double-blind study

Abstract

Fosaprepitant was more effective than ondansetron in decreasing the incidence of vomiting after lower limb surgery with postoperative opioid administration. Meanwhile, fosaprepitant was not inferior to ondansetron in decreasing the incidence and severity of PONV.

Analgesic Efficacy of Bilateral Ilioinguinal and Iliohypogastric Nerve Block for Post Caesarean Delivery Under Spinal Anaesthesia, 2016. Double blind randomized Study

“…However, the merits of landmark technique using "double pop" method regarding safety and certainty have been reported [2,3,12,27]. However; ultrasound guidance for regional anesthesia has not been decisively established to improve safety [28,29].…”

The role of neurokinin-1 (substance P) antagonists in the prevention of postoperative nausea and vomiting

“…Fosaprepitant, a pro-drug is available for intravenous administration, with a typical dose of 115 mg.[ 30 ] Fosaprepitant, is only Food and Drug Administration approved for use in CINV although it has been shown to more effective than ondansetron in reducing vomiting in gynecologic, neurological, and lower limb surgeries. [ 32 33 34 ] Aprepitant is relatively safe; however, common side effects include dizziness, constipation, and hypotension, especially when used in the setting of PONV prophylaxis. In the setting of CINV prophylaxis, common side effects are fatigue, diarrhea, weakness, indigestion, abdominal pain, hiccups, leukopenia, dehydration and altered liver function tests, cough, and hiccups.…”

A Comparison of Fosaprepitant and Ondansetron for Preventing Postoperative Nausea and Vomiting in Moderate to High Risk Patients: A Retrospective Database Analysis

“…A dose of 115 mg of fosaprepitant was reported equivalent to 125 mg of aprepitant [ 10 ], with intravenous administration of 150 mg of fosaprepitant showing the same efficacy as a 3-day oral aprepitant treatment (125/80/80 mg) [ 21 ]. In our previous studies [ 15 – 17 ], we demonstrated the efficacy of fosaprepitant in preventing PONV in patients undergoing general anesthesia compared to ondansetron. This study enrolled moderate to high PONV risk patients and confirmed fosaprepitant efficacy compared to ondansetron.…”

“…Recently, we reported that fosaprepitant was more effective than ondansetron in preventing vomiting 0–24 and 0–48 h after surgery [ 15 – 17 ]. In this study, we collected data from our previous studies and evaluated the efficacy of fosaprepitant in preventing PONV compared to ondansetron in moderate to high PONV risk patients.…”