Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
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.
Gomberg, Rebeccah M., "Is Aprepitant Effective in Preventing Postoperative Nausea and Vomiting?" (2016). PCOM Physician Assistant Studies Student Scholarship. 286.