Clinical efficacy of fosaprepitant for pretreatment of postoperative nausea and vomiting following gynecological laparoscopic surgery
10.3760/cma.j.cn131073-20241020-01005
- VernacularTitle:福沙匹坦防治妇科腹腔镜手术后恶心呕吐的临床效应
- Author:
Yuzhong XIA
1
;
Yingying ZHAO
1
;
Hua SHAO
1
;
Qiong XUE
1
;
Ying WANG
1
;
Kun LIU
1
;
Jianjun YANG
1
Author Information
1. 郑州大学第一附属医院麻醉与围手术期及疼痛医学部，郑州 450052
- Publication Type:Journal Article
- Keywords:
Neurokinin-1 receptor antagonists;
Postoperative nausea and vomiting;
Laparoscopy;
Gynecologic surgical procedures
- From:
Chinese Journal of Anesthesiology
2025;45(10):1255-1258
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effectiveness of fosaprepitant in preventing postoperative nausea and vomiting (PONV) following gynecological laparoscopic surgery.Methods:In this randomized parallel-controlled trial, 100 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-64 yr, undergoing elective gynecological laparoscopic surgery under general anesthesia at the First Affiliated Hospital of Zhengzhou University, were selected and divided into 2 groups ( n=50 each) in a ratio of 1∶1 using blocked randomization: fosaprepitant group (group F) and tropisetron group (group T). At 30 min before anesthesia induction, fosaprepitant 150 mg was intravenously infused in group F, and tropisetron 5 mg was intravenously infused in group T, both diluted in 150 ml of normal saline. Anesthesia was induced by intravenous injection of midazolam, etomidate, sufentanil and cisatracurium. Anesthesia was maintained by intravenous infusion of remifentanil and propofol. Patient-controlled intravenous analgesia was performed with hydromorphone at the end of operation until 48 h after operation. Metoclopramide was given as rescue antiemetic. The PONV, requirement for antiemetic drugs and related adverse reactions were recorded within 24 h after surgery. Results:The incidence of PONV (10% vs 30%), the incidence of vomiting(2% vs 16%) and the rescue rate of antiemetic drugs(2% vs 12%)were significantly lower in group F than in group T ( P<0.05). There was no significant difference in the incidence of related adverse reactions between the two groups ( P>0.05). Conclusions:Intravenous infusion of fosaprepitant 150 mg at 30 min before anesthesia induction effectively prevents PONV in patients undergoing gynecological laparoscopic surgery, and the efficacy is superior to that of the conventional use of tropisetron.
