THE EFFICACY OF APREPITANT (NK-1 RECEPTOR ANTAGONIST) AS PROPHYLAXIS FOR POSTOPERATIVE NAUSEA AND VOMITING

Objective: To assess the effectiveness of Aprepitant (NK-1 receptor antagonist) for prophylaxis of postoperative nausea and vomiting in middle aged female patients undergoing laparoscopic cholecystectomy under General Anesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Lahore, from Jun 2018 to Dec 2018. Methodology: Four hundred American Society of Anesthesiologists (ASA) I and II middle aged female patients undergoing laparoscopic cholecystectomy under general anesthesia were recruited. Patients were divided into two groups of 200 each as “A” (Aprepitant) and “P” (Placebo). Forty miligrams Aprepitant was given to A-group patients, whereas P-group was given empty capsule. Patients were given standardized general anesthesia and were observed and documented for incidence and severity of early (0-2 hours) and delayed (2-24 hours) periods for episodes of postoperative nausea and vomiting. Results: In A-group 20 (10%) had nausea, 8 (4%) had vomiting. Only 4 (2%) needed rescue anti-emetic. In P-group 84 (42%) had nausea and 76 (38%) had vomiting, 21 (10.5%) needed rescue antiemetic. The difference between the two groups was found statistically significant. Conclusion: Preemptive use of Aprepitant (NK-1 receptor antagonist) reduces the incidence of postoperative nausea and vomiting and need for rescue anti-emetic.