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Title: Comparison of aprepitant and dexamethasone versus metoclorpramide and dexamethasone for prevention of post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.
Authors: Zerwah Muhammad Qayum, Aftab Hussain, Muhammad Akram, Muhammad Asif Saleem, Rehana Feroze, Faisal Wahid
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2022
Volume: 29
Issue: 1
Language: English
DOI: 10.29309/TPMJ/2022.29.01.6604
Keywords: DexamethasoneLaparoscopic cholecystectomyAprepitantPost-Operative Nausea and Vomiting
Objective: To compare the efficacy of aprepitant and dexamethasone versus metoclopramide and dexamethasone combination in prevention of post-operative nausea and vomiting in females undergoing laparoscopic cholecystectomy. Study Design: Prospective Comparative study. Setting: Department of Anesthesia, CMH Lahore. Period: October 2019 to April 2020. Material & Methods: A total of 140 female patients planned for laparoscopic cholecystectomy under general anesthesia, of age ranges from 35-65 years and ASA classification I and II were recruited for the study and were divided into two equal groups. In group A (n=70), patients were given oral aprepitant 80 mg with once sip of water one hour prior to induction and dexamethasone 8 mg upon induction. In group M (n=70), patients were given a placebo one hour prior to induction and intravenous metoclopramide 10 mg and dexamethasone 8 mg upon induction. Results: Age range in this study was from 37 to 65 years with mean age of 46.82 ± 7.29 years. The mean age of patients in group A was 45.73 ± 6.77 years and in group M was 47.91 ± 7.66 years with p-value of 0.076. In our study, significant difference was found between the efficacy of two groups of drugs. The efficacy of aprepitant and dexamethasone was found in 62 (88.57%) patients, while with metoclopramide and dexamethasone, it was found in 51 (72.86%) patients with p-value of 0.031. Conclusion: it is concluded that aprepitant and dexamethasone combination has higher efficacy as compared to metoclorpromide and dexamethasone in prevention of post-operative nausea and vomiting in elective laparoscopic cholecystectomy.
To compare the efficacy of aprepitant and dexamethasone versus metoclopramide and dexamethasone in preventing post-operative nausea and vomiting (PONV) in female patients undergoing laparoscopic cholecystectomy.
Prospective comparative study involving 140 female patients aged 35-65 years with ASA classification I and II undergoing laparoscopic cholecystectomy under general anesthesia. Patients were divided into two equal groups: Group A (n=70) received oral aprepitant 80 mg one hour prior to induction and dexamethasone 8 mg upon induction; Group M (n=70) received a placebo one hour prior to induction and intravenous metoclopramide 10 mg and dexamethasone 8 mg upon induction. Data was analyzed using statistical software, with a p-value of 0.05 considered significant.
graph TD;
A["Recruit 140 Female Patients for Laparoscopic Cholecystectomy"] --> B["Divide into Two Groups"A & M""];
B --> C["Group A: Aprepitant + Dexamethasone"];
B --> D["Group M: Metoclopramide + Dexamethasone"];
C --> E["Administer Pre-operative Medications"];
D --> E;
E --> F["Induction of General Anesthesia"];
F --> G["Perform Laparoscopic Cholecystectomy"];
G --> H["Monitor for Post-operative Nausea and Vomiting"];
H --> I["Collect and Analyze Data"];
I --> J["Compare Efficacy of Both Groups"];
J --> K["Draw Conclusion"];
PONV is a common adverse effect of general anesthesia and surgery. The study suggests that the combination of aprepitant and dexamethasone is more effective than metoclopramide and dexamethasone in preventing PONV in patients undergoing laparoscopic cholecystectomy. This finding is supported by the understanding of NK1 receptor antagonists and their role in emesis pathways.
The combination of aprepitant and dexamethasone was effective in preventing PONV in 88.57% of patients, while the combination of metoclopramide and dexamethasone was effective in 72.86% of patients (p-value = 0.031). The mean age and BMI were comparable between the two groups.
The combination of aprepitant and dexamethasone demonstrates higher efficacy in preventing post-operative nausea and vomiting compared to metoclopramide and dexamethasone in elective laparoscopic cholecystectomy. The study recommends the routine use of aprepitant and dexamethasone for patients undergoing general anesthesia to reduce PONV.
1. Sample Size: The study recruited a total of 140 female patients, divided into two equal groups of 70 each.
2. Efficacy Rates: Aprepitant and dexamethasone combination showed efficacy in 88.57% of patients, while metoclopramide and dexamethasone showed efficacy in 72.86% of patients.
3. Study Period: The study was conducted over a six-month period from October 2019 to April 2020.
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