Comparison of the effects of Aprepitant and Granisetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing Laparoscopic Cholecystectomy: A double-blind, randomized, controlled study

Background: Postoperative nausea and vomiting (PONV) is one of the most common findings in the first 24 hours after surgery, occurring in 30% of all patients and up to 80% of high-risk patients. We compared aprepitant (a neurokinin-1 receptor antagonist) and granisetron in preventing PONV in patients who underwent laparoscopic cholecystectomy (LC). Methods: Sixty-one patients (aged 18-90) and the American Society of Anesthesiologists (ASA) I-II class who underwent LC under general anesthesia were enrolled in the study. Our study aimed to compare the incidence of PONV between 0-6, 6-12, and 6-24 hours postoperatively and the need for additional antiemetic requirements primarily and, secondly, detecting VAS scores and additional analgesic requirements for aprepitant and granisetron. Results: Our study observed similar PONV changes in both groups at 0-6 hours. A significantly lower VDS was observed in group A at 30-60 minutes compared to group G (p=0.10). There was no significant difference between groups at other intervals until the 120th minute. Between 6 and 12 hours, Group A had a lower VDS (Verbal Descriptive Scale) than Group G, but there was no statistically significant difference (P>0.05). There was no significant difference between the groups regarding VAS scores, additional analgesic requirements, and adverse effects on patients (p>0.05). Conclusion: We observed that aprepitant may be more effective than granisetron in preventing PONV and can be used safely in patients undergoing LC.