Page 41 - World Journal of Laparoscopic Surgery

RESEARCH ARTICLE
Comparison of the Effects of Aprepitant and Ondansetron

Individually and Combining on Postoperative Nausea and

Vomiting after Laparoscopic Cholecystectomy

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Farhang Safarnejad , Karim Nasseri , Reza Karami 3
AbstrAct
Background: Nausea and vomiting are one of the most common postoperative complications that cause unpleasant feelings and delays in the
discharge of patients. This study aimed to compare the effect of aprepitant, ondansetron, and their combination on the severity of nausea and
vomiting after this procedure for finding a safe and less indisposition regimen.
Materials and methods: This study was performed on patients aged 18–50 who had been diagnosed with symptomatic cholelithiasis and who
underwent laparoscopic cholecystectomy under general anesthesia. This study was done single-blinded. Patients were categorized into three
groups (the recipient of aprepitant, the recipient of ondansetron, and the group receiving ondansetron and aprepitant simultaneously) and
the rate of nausea and vomiting was measured at 6 and 24 hours after the operation.
Results: The results of one-way analysis of variance analysis and Kruskal–Wallis showed that there was a significant difference between the
treatment groups regarding the severity of nausea and vomiting after surgery (p < 0.001). The severity of nausea and vomiting in the group
receiving ondansetron plus aprepitant is less than the other two groups.
Conclusion: A combination of ondansetron plus aprepitant can reduce nausea and vomiting after surgery while the effect of aprepitant is
much more than ondansetron.
Keywords: Aprepitant, Cholecystectomy, Ondansetron, Vomiting.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1440

IntroductIon 1 Department of Surgery, School of Medicine, Kurdistan University of
Nausea and vomiting are common serious postoperative Medical Sciences, Sanandaj, Kurdistan Province, Iran
complications that cause unpleasant feelings and hospital stay 2 Department of Anesthesiology, Faculty of Medicine, Kurdistan
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elongation. The annual cost of postoperative nausea and vomiting University of Medical Sciences, Sanandaj, Kurdistan Province, Iran
has been reported in the United States for several hundred million 3 Department of Minimal Invasive Surgery, School of Medicine, Iran
2
dollars. Postoperative nausea and vomiting in 20–30% of patients University of Medical Sciences, Tehran, Iran
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and are the second most common postoperative complications. Corresponding Author: Reza Karami, Department of Minimal Invasive
4
Its incidence is 37–90% without prophylaxis. Nausea and vomiting Surgery, School of Medicine, Iran University of Medical Sciences, Tehran,
may lead to serious but rare complications of aspiration and Iran, Phone: +98 9133415767, e-mail: reza_karami1367@yahoo.com
postoperative hypoxemia, fluid and electrolyte disorders, and How to cite this article: Safarnejad F, Nasseri K, Karami R. Comparison
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dehiscence of the surgical site. Some factors, such as age, sex, of the Effects of Aprepitant and Ondansetron Individually and
previous history of nausea and vomiting, motion sickness, type Combining on Postoperative Nausea and Vomiting after Laparoscopic
of surgery, duration of anesthesia and surgery, and anxiety of the Cholecystectomy. World J Lap Surg 2021; 14(1):39–42.
patient and parents are the factors influencing nausea and vomiting, Source of support: This study was funded by Kurdistan University of
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which cannot be controlled by the anesthesiologist. Some studies medical sciences

demonstrated that type of operation may be associated with Conflict of interest: None
postoperative nausea and vomiting, but there are controversies
in this regard. 1
An increase in surgery and anesthesia duration leads to an
increase in the risk of nausea and vomiting, which is probably due to premedication, type of anesthesia, anesthetic drugs during surgery,
the accumulation of anesthetizing agents. The incidence of nausea postoperative management, and anti-anesthetic drugs. It has been
and vomiting rises from 2.8% in patients with a duration of less than reported that patients who receive general anesthesia are 11 times
30 minutes to 27% in patients with an operation duration between more likely to have nausea and vomiting after surgery than those
151 minutes and 180 minutes. The duration of anesthesia increases who receive regional or block anesthesia for the treatment of
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the risk of nausea and vomiting up to 59% per 30 minutes. Of course, chronic pain. The use of intubation due to stimulation of pharyngeal
some of the factors affecting the development of postoperative mechanoreceptors is believed to be associated with an increased
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vomiting and vomiting are under the control of anesthesiologists risk of postoperative nausea and vomiting. Choosing the right
who need to pay attention to controlling this complication, including treatment and appropriate intervention in controlling nausea

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