Ondansetron vs. Aprepitant for PONV in orthognathic surgeries: A trial

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Created On: 19/04/2024

This study sought to compare the effectiveness of Aprepitant and Ondansetron in preventing postoperative nausea and vomiting (PONV) after jaw surgeries.

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Key take away

When compared to Ondansetron, Aprepitant is more effective to prevent PONV (a common side effect of general anesthesia) after orthognathic surgery.

Background

This study sought to compare the effectiveness of Aprepitant and Ondansetron in preventing postoperative nausea and vomiting (PONV) after jaw surgeries.

Method

This double-blinded research encompassed 80 patients undergoing orthognathic surgery. Volunteers were randomly segregated into two groups. All the enrolled subjects received a standardized anesthesia protocol. The first group was administered a placebo capsule 1 hour prior to surgery, along with 4 mg (2 ml) of intravenous Ondansetron following anesthesia induction.

One hour prior to surgery, the second group was administered 80 mg Aprepitant capsules. This was followed by a 2 ml intravenous distilled water injection following the elicitation of anesthesia. Patient response, PONV occurrence and severity, and rescue medication usage were evaluated within 24 hours post-surgery.

Result

In this randomized controlled trial, there were no profound demographic differences between the groups. Those receiving Aprepitant experienced considerably lower incidence and intensity of nausea, vomiting, and required fewer rescue medications compared to those receiving Ondansetron. Moreover, the Aprepitant arm illustrated a greater complete response rate during the 0-2 and 12-24 postsurgery hours, as shown in Table 1:

Conclusion

Aprepitant demonstrated superior efficacy in evading PONV compared to Ondansetron, with lower incidence and severity of symptoms and minimized the need for rescue medication. Furthermore, Aprepitant elicited a better complete response rate during the 0-2 and 12-24 postsurgery hours.