Fosaprepitant dimeglumine combined with palonosetron for the prevention and treatment of postoperative nausea and vom-iting after gynecological laparoscopy
Objective To evaluate the feasibility and safety of fosaprepitant dimeglumine combined with palonosetron for the prevention and treatment of postoperative nausea and vomiting(PONV)after gynecologic laparoscopy.Metheods A total of 180 pa-tients undergoing gynecological laparoscopic surgery were selected.According to the random number table method,they were divided into three groups(n=60):a palonosetron group(group A),a fosaprepitant dimeglumine group(group B),and a fosaprepitant dimeglu-mine combined with palonosetron group(group C).Group A received 0.075 mg palonosetron,group B was treated with 150 mg fosaprep-itant dimeglumine,and group C received fosaprepitant dimeglumine 150 mg plus palonosetron 0.075 mg.Their PONV incidence at postoperative 2 h,on postoperative days 1 and 2,Visual Analogue Scale(VAS)scores on postoperative days 1 and 2,analgesia satisfac-tion scores,the number of PONV rescue cases(additional use of antiemetic agent metoclopramide/dexamethasone due to intolerance to vomiting)and the number of rescue analgesia cases within 2 d after surgery.The duration of operation,remifentanil dosage,the volume of blood loss,fluid intake,and the incidence of drug-related adverse reactions were recorded.Results At postoperative 2 h,com-pared with group A,group C showed increases in the number of patients with grade 0 PONV,and decreases in the number of patients with grades 1,2,and 3 PONV(all P＜0.05).On postoperative days 1 and 2,compared with groups A and B,group C presented increases in the number of patients with grade 0 PONV,and decreases in the number of patients with grades 1,2,and 3 PONV(all P＜0.05).Com-pared with groups A and B,the satisfaction towards postoperative analgesia increased in group C(all P＜0.05).There was no statistical difference in postoperative VAS scores among the three groups(all P＞0.05).Furthermore,no statistical difference was found in the du-ration of operation,remifentanil dosage,the volume of blood loss,fluid intake,the number of PONV rescue cases and the number of res-cue analgesia cases among the three groups(all P＞0.05).No drug-related adverse reactions occurred in the three groups.Conclu-sion The combined use of fosaprepitant dimeglumine and palonosetron is effective and safe to prevent PONV in patients undergoing laparoscopic gynecological surgery.
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