Bariatric Surgery Department, Baja Hospital, Ernesto Sarmiento 2308, Burócrata, Ruiz Cortines, 22046, Tijuana, BCN, Mexico.
Anesthesiology department, Baja Hospital, Ernesto Sarmiento 2308, Burócrata, Ruiz Cortines, 22046, Tijuana, BCN, Mexico.
Obes Surg. 2024 Apr;34(4):1316-1323. doi: 10.1007/s11695-024-07129-0. Epub 2024 Mar 2.
Laparoscopic sleeve gastrectomy (LSG) is associated with postoperative nausea and vomiting (PONV). We aimed to compare the effects of aprepitant on the incidence of PONV after LSG.
In this double-blind, randomized controlled trial, the case group received the standard care regimen for PONV (dexamethasone 10 mg, ondansetron 4 mg, and metoclopramide 10 mg) plus prophylactic oral aprepitant 80 mg 1 h preoperatively. The control group received standard care plus a placebo. Comparative analyses using the Rhodes index were performed at 0, 6, 12, and 24 h postoperatively.
A total of 400 patients (201 in the aprepitant group and 199 in the placebo group) underwent LSG. The groups were homogeneous. The aprepitant group experienced less PONV: early, 69 (34.3%) vs. 103 (51.7%), p ≤ 0.001; 6 h, 67 (33.3%) vs. 131 (65.8%), p ≤ 0.001; 12 h, 41 (20.4%) vs. 115 (57.8%), p ≤ 0.001; and 24 h, 22 (10.9%) vs. 67 (33.7%), p ≤ 0.001. Fewer patients in the aprepitant group vomited: early, 3 (1.5%) vs. 5 (2.5%), p = 0.020; 6 h, 6 (3%) vs. 18 (9%), p = 0.020; 12 h, 2 (1%) vs. 17 (8.5%), p = 0.006; and 24 h, 1 (0.5%) vs. 6 (3%), p = 0.040. Patients in the aprepitant group required less additional PONV medication: early, 61 (30.3%) vs. 86 (43.2), p = 0.008; 6 h, 7 (3.5%) vs. 34 (17%), p = 0.001; 12 h, 6 (3%) vs. 31 (15.6%), p ≤ 0.001; and 24 h, 5 (2.5%) vs. 11 (5.5%), p ≤ 0.001.
Prophylactic aprepitant improved PONV between 0 h (early) and 24 h postoperatively in patients undergoing LSG.
腹腔镜袖状胃切除术（LSG）与术后恶心和呕吐（PONV）有关。我们旨在比较阿瑞匹坦对 LSG 后 PONV 发生率的影响。
在这项双盲、随机对照试验中，病例组在术前 1 小时接受标准 PONV 预防方案（地塞米松 10mg、昂丹司琼 4mg 和甲氧氯普胺 10mg）加预防性口服阿瑞匹坦 80mg。对照组接受标准护理加安慰剂。在术后 0、6、12 和 24 小时使用 Rhodes 指数进行比较分析。
共有 400 名患者（阿瑞匹坦组 201 名，安慰剂组 199 名）接受了 LSG。两组同质。阿瑞匹坦组 PONV 发生率较低：早期，69（34.3%）比 103（51.7%），p≤0.001；6 小时，67（33.3%）比 131（65.8%），p≤0.001；12 小时，41（20.4%）比 115（57.8%），p≤0.001；24 小时，22（10.9%）比 67（33.7%），p≤0.001。阿瑞匹坦组呕吐的患者较少：早期，3（1.5%）比 5（2.5%），p=0.020；6 小时，6（3%）比 18（9%），p=0.020；12 小时，2（1%）比 17（8.5%），p=0.006；24 小时，1（0.5%）比 6（3%），p=0.040。阿瑞匹坦组需要更少的额外 PONV 药物：早期，61（30.3%）比 86（43.2%），p=0.008；6 小时，7（3.5%）比 34（17%），p=0.001；12 小时，6（3%）比 31（15.6%），p≤0.001；24 小时，5（2.5%）比 11（5.5%），p≤0.001。
预防性阿瑞匹坦可改善 LSG 术后 0 小时（早期）至 24 小时的 PONV。
