Comparing Efficacy of Aprepitant, Ondansetron and Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Surgery Under General Anaesthesia

Background and Aims: Nausea and vomiting are one of the most common postoperative complications that causes an unpleasant feeling and delay in the discharge of patients. This study aimed to compare the effect of Aprepitant. Ondansetron, and Dexamethasone in preventing PONV inpatients undergoing surgery under general anesthesia. Material and Methods: This study was performed on 90 patients aged 18-60years undergoing surgery under general anesthesia of ASA grade 1 and 2. It was a single blinded randomized trial and patients were categorized into three groups of 30 patients each, who receive inj. Ondansetron 10mg IV and inj. dexamethasone 8mg iv both 10 min before induction and cap. Aprepitant 40mg orally 2hr before induction of anesthesia. After extubation patients were monitored for nausea, retching and vomiting for 30min, 60min, 2hr, 6hr 12hr, and 24 hr in the postoperative period. Results: The incidence rate for primary end point i.e complete response, no vomiting and no use of rescue drug over 0-24hour after surgery, which tested for effectivity of aprepitant, dexamethasone, and Ondansetron were not different across groups (96.7%aprepitant group,90.0% in ondansetron group and 93.3% in dexamethasone group at end of 24hour. However, the incidence of no vomiting at 12-24hour in both Aprepitant and dexamethasone both drugs were superior than ondansetron (10%). Although demand of rescue medicine and nausea control was not different. Conclusion: Aprepitant and Dexamethasone both have slightly lower prophylactic antiemetic efficacy in early phase after surgery but in delayed phase (12- 18hr) both were effective in preventing PONV as compared to Ondansetron. At the end of 24 hour all the three drugs were effective in reducing vomiting episodes and there was less need of any rescue medicine.