Date of Award

2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aprepitant is effective in preventing postoperative nausea and vomiting.

STUDY DESIGN: Review of three English language primary randomized controlled trials from 2012-2014.

DATA SOURCES: Three double-blind, randomized controlled trials comparing oral aprepitant with placebo. All articles were found using PubMed.

OUTCOMES MEASURED: The three studies measured nausea severity using a verbal rating system and number of episodes of nausea and vomiting recorded by a blinded study investigator.

RESULTS: Vallejo et al found that 29.7% of the patients in the placebo group vomited compared to 9.3% of the patients who received aprepitant (p = 0.003). They also found that the worst VRS nausea score was a 5 out of 10 in the group of patients who received aprepitant versus 8 out of 10 for the placebo group (p = 0.014). Jung et al found that the groups that received aprepitant had a 35% incidence of nausea compared to 63% in the placebo group (p = 0.0025). In addition, the aprepitant groups both had 0% incidence of vomiting compared to the placebo group, which had a 20% incidence (p = 0.005). Sinha et al found that incidence of vomiting at 72 hours was 3.1% in the experimental group and 15.0% in the placebo group (p = 0.021). In all of the studies, mean VRS nausea scores were lower but were not found to be statistically significant.

CONCLUSIONS: Aprepitant is effective in preventing incidence of nausea and vomiting, but is not found to significantly decrease average nausea rating scores.

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