DOI: 10.36347/sjams.2014.v02i03.030

Pages: 1020-1027

Nausea, vomiting and retching are one of the commonest complaints experienced among post operative period. Post operative nausea & vomiting exposes the patient to unusual distress & stress. The aim of study is to compare the efficacy and safety of Aprepitant (NK-1 Antagonist) and Ondansetron (5-HT3 antagonist) in prophylaxis of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. In a randomized-double-blinded prospective trial 90 patients of 20-60yrs and ASA (American society of anesthesiologists) I and II were allocated into 3 groups. Group C received placebo tablets orally 3 hrs and 2ml of normal saline intravenous (IV) 10 Min prior to induction. Group O received placebo tablets orally 3 hrs and Ondansetron 4mg IV 10 min prior to induction. Group A received 40 mg Aprepitant oral 3 hrs and 2ml of normal saline IV 10 Min prior to induction. Efficacy of antiemetic was assessed for 0-24 hrs, 24-48 hrs after surgery. Nausea was recorded on 11 point ordinal scale, vomiting episode, doses of rescue antiemetic and adverse effects were noted and statistically analyzed. There were statistically similar nausea scores (Verbal rating scores) in both Group A and Group O at 0-24 hrs (P=0.192). Thereafter also at 24-48 hrs nausea scores remained similar in Group A and Group O (p=0.052). Episodes of vomiting were similar at 0-24 hrs (P=0.267) but at 24- 48 hrs, it were less in Group A (P=0.023). In conclusion, prophylactic Ondansetron 4mg IV and Aprepitant 40mg oral are equally effective in early PONV, but Aprepitant because of its long acting effect and delayed vomiting effect can be considered to prevent delayed PONV.