Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.
Korean J Anesthesiol. 2013 Mar;64(3):212-7. doi: 10.4097/kjae.2013.64.3.212. Epub 2013 Mar 19.
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.
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.
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.
Oral aprepitant 125 mg can be used as combination therapy for the prevention of PONV.
5-HT3 受体拮抗剂、地塞米松和氟哌利多被用于预防术后恶心和呕吐（PONV）。最近，神经激肽-1（NK1）拮抗剂也被用于预防 PONV。我们评估了在昂丹司琼的基础上加用口服阿瑞匹坦的效果。
90 例择期行耳鼻喉科手术的患者被随机分为三组（对照组、Ap80 组、Ap125 组），每组 30 例。所有患者均在手术结束前静脉注射昂丹司琼 4mg。手术当天早晨，Ap80 组和 Ap125 组分别额外给予 80mg 和 125mg 阿瑞匹坦。在术后 6 小时和 24 小时评估恶心、呕吐和干呕的 Rhodes 指数（RINVR）。
12 例使用类固醇的患者意外被排除。最终有 78 例患者（对照组：Ap80 组：Ap125 组=24：28：26）纳入研究。Ap125 组在术后 6 小时的 PONV 总发生率（1/26，3.9%）低于对照组（7/24，29.2%）（P=0.015）。Ap125 组在术后 6 小时的恶心严重程度评分（0.04±0.20）低于对照组（0.67±1.24）（P=0.032）。阿瑞匹坦无明显副作用。
口服阿瑞匹坦 125mg 可作为预防 PONV 的联合治疗方案。
