Comparing the antiemetic efficacy of ondansetron and aprepitant in female patients undergoing mastectomy / thyroidectomy

ASA 1 and 2 women, aged 18 to 65 years scheduled for thyroidectomy / mastectomy were randomised for the study. On the day of surgery, patients received either capsule aprepitant 40 mg along with premedication or injection ondansetron 8 mg IV 3 doses Q8h post operatively. The incidence of PONV were compared using chi square test. The severity of nausea was compared using Mann-Whitney non parametric test

Most patients in ondansetron group (n=59) and aprepitant group (n=61) did not have vomiting at 0-2 hours (79.7 vs 85.2%), 2-12 hours (86.4% vs 85.2%) and 12- 24 hours (100% vs 95.1%) postoperatively. The incidence of vomiting in the ondansetron and aprepitant group at 0-2 hours (20.4% vs 16.4%), 2-12 hours ( 13.6% vs 14.7%) and 12-24 hours (0% vs 4.9%) was not significant between the 2 groups. The nausea severity, number of emetic episodes, time to first emesis and the use of rescue antiemetics were comparable in both groups

A single dose of oral aprepitant has comparable effects to 3 doses of injection ondansetron administered Q8h in preventing PONV in the first postoperative day. This can also be used in day care surgeries thus avoiding the need for IV injection for 24 hours