NK1 receptor antagonists versus other antiemetics in the prevention of postoperative nausea and vomiting following laparoscopic surgical procedures: a systematic review and meta-analysis

Abstract

A systematic electronic search of MEDLINE, EMBASE, and CINAHL databases aimed at comparing neurokinin-1 receptor antagonists with other antiemetics in their prevention of postoperative nausea and vomiting in adult patients undergoing laparoscopic surgery identified seven randomized controlled trials for review and meta-analysis. Preoperative aprepitant 80 mg was found to reduce nausea (RR: 0.56, 95% CI: 0.41-0.75, I 2 = 0%, P = 0.89) and vomiting (RR: 0.20, 95% CI: 0.05-0.77, I 2 = 0%, P = 0.96) and resulted in complete response (RR: 1.61 (1.25-2.08), I 2 = 0%, P = 0.70) within the first 2 hours following surgery as well as vomiting in 2-24 hours (RR: 0.09, 95% CI: 0.02-0.36, I 2 = 0%; P = 0.81) when compared to placebo or no antiemetic therapy. Preoperative aprepitant 80 mg has a superior overall effect compared to placebo or other antiemetics in the first two hours postoperatively, and thereafter reduces the risk of vomiting alone in the first 24 hours following laparoscopic surgeries.