Tags

Type your tag names separated by a space and hit enter

[Neurokinin-1 receptor antagonists for postoperative nausea and vomiting: a systematic review and meta-analysis].
Braz J Anesthesiol. 2020 Sep - Oct; 70(5):508-519.BJ

Abstract

BACKGROUND

Postoperative Nausea and Vomiting (PONV) is a common complication of general anesthesia. Several kinds of antiemetics, including 5-Hydroxytryptamine3 (5-HT3) receptor antagonists and Neurokinin-1 (NK-1) receptor antagonists, have been used to treat PONV.

OBJECTIVES

To compare the antiemetic effect of NK-1 receptor antagonists, including fosaprepitant.

DATA SOURCES

Online databases (PubMed, MEDLINE, Scopus, The Cochrane Library databases) were used.

STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS

Randomized Controlled Trials (RCTs) performed in patients over 18 years with ASA-PS of I-III, aimed to assess the efficacy of antiemetics including NK-1 receptor antagonists and 5-HT3 receptor antagonists, and compared the incidence of PONV were included.

STUDY APPRAISAL AND SYNTHESIS METHODS

All statistical assessments were conducted by a random effect approach and odds ratios and 95% Confidence Intervals were calculated.

RESULTS

Aprepitant 40mg and 80mg significantly reduced the incidence of vomiting 0-24hours postoperatively (Odds Ratio [OR = 0.40]; 95% Confidence Interval [95% CI 0.30-0.54]; p < 0.001, and OR = 0.32; 95% CI 0.19-0.56; p < 0.001). Fosaprepitant could also reduce the incidence of vomiting significantly both 0-24h and 0-48hours postoperatively (OR = 0.07; 95% CI 0.02-0.24; p < 0.001 and OR = 0.07; 95% CI 0.02-0.23; p < 0.001).

LIMITATIONS

Risk factors for PONV are not considered, RCTs using multiple antiemetics are included, RCTs for fosaprepitant is small, and some bias may be present.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

Aprepitant and fosaprepitant can be effective prophylactic antiemetics for postoperative vomiting. However, more studies are required for higher-quality meta-analyses.

SYSTEMATIC REVIEW REGISTRATION NUMBER

CRD42019120188.

Links

Authors+Show Affiliations

Tokushima University, Department of Anesthesiology, Kumamoto, Japão.

Tokushima University, Department of Anesthesiology, Kumamoto, Japão.

University of California, Department of Anesthesiology, San Diego, EUA.

Hiroshima University, Department of Anesthesiology and Critical Care, Minami, Japão.

Hiroshima University, Department of Anesthesiology and Critical Care, Minami, Japão.

Hiroshima University, Department of Anesthesiology and Critical Care, Minami, Japão.

Hiroshima University, Department of Anesthesiology and Critical Care, Minami, Japão.

Hiroshima University, Department of Anesthesiology and Critical Care, Minami, Japão.

Osaka Dental University, Department of Anesthesiology, Chuo, Japão.

Tokushima University, Department of Anesthesiology, Kumamoto, Japão.

Hiroshima University, Department of Anesthesiology and Critical Care, Minami, Japão. Electronic address: yasuo223@hiroshima-u.ac.jp.

MeSH

Anesthesia, GeneralAntiemeticsHumansIncidenceMorpholinesNeurokinin-1 Receptor AntagonistsPostoperative Nausea and VomitingRandomized Controlled Trials as TopicSerotonin 5-HT3 Receptor Antagonists

Pub Type(s)

Comparative Study

Journal Article

Meta-Analysis

Systematic Review

Language

por

PubMed ID

32753114

Citation

Murakami, Chiaki, et al. "[Neurokinin-1 Receptor Antagonists for Postoperative Nausea and Vomiting: a Systematic Review and Meta-analysis]." Brazilian Journal of Anesthesiology (Elsevier), vol. 70, no. 5, 2020, pp. 508-519.

Murakami C, Kakuta N, Satomi S, et al. [Neurokinin-1 receptor antagonists for postoperative nausea and vomiting: a systematic review and meta-analysis]. Braz J Anesthesiol. 2020;70(5):508-519.

Murakami, C., Kakuta, N., Satomi, S., Nakamura, R., Miyoshi, H., Morio, A., Saeki, N., Kato, T., Ohshita, N., Tanaka, K., & Tsutsumi, Y. M. (2020). [Neurokinin-1 receptor antagonists for postoperative nausea and vomiting: a systematic review and meta-analysis]. Brazilian Journal of Anesthesiology (Elsevier), 70(5), 508-519. https://doi.org/10.1016/j.bjan.2020.04.005

Murakami C, et al. [Neurokinin-1 Receptor Antagonists for Postoperative Nausea and Vomiting: a Systematic Review and Meta-analysis]. Braz J Anesthesiol. 2020 Sep - Oct;70(5):508-519. PubMed PMID: 32753114.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - [Neurokinin-1 receptor antagonists for postoperative nausea and vomiting: a systematic review and meta-analysis]. AU - Murakami,Chiaki, AU - Kakuta,Nami, AU - Satomi,Shiho, AU - Nakamura,Ryuji, AU - Miyoshi,Hirotsugu, AU - Morio,Atsushi, AU - Saeki,Noboru, AU - Kato,Takahiro, AU - Ohshita,Naohiro, AU - Tanaka,Katsuya, AU - Tsutsumi,Yasuo M, Y1 - 2020/07/07/ PY - 2019/11/05/received PY - 2020/03/23/revised PY - 2020/04/12/accepted PY - 2020/8/6/pubmed PY - 2021/9/10/medline PY - 2020/8/6/entrez KW - Antagonistas do receptor NK‐1 KW - NK‐1 receptor antagonists KW - Náusea e vômito no pós‐operatório KW - Postoperative nausea and vomiting KW - Profilaxia KW - Prophylaxis KW - Tratamento KW - Treatment SP - 508 EP - 519 JF - Brazilian journal of anesthesiology (Elsevier) JO - Braz J Anesthesiol VL - 70 IS - 5 N2 - BACKGROUND: Postoperative Nausea and Vomiting (PONV) is a common complication of general anesthesia. Several kinds of antiemetics, including 5-Hydroxytryptamine3 (5-HT3) receptor antagonists and Neurokinin-1 (NK-1) receptor antagonists, have been used to treat PONV. OBJECTIVES: To compare the antiemetic effect of NK-1 receptor antagonists, including fosaprepitant. DATA SOURCES: Online databases (PubMed, MEDLINE, Scopus, The Cochrane Library databases) were used. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Randomized Controlled Trials (RCTs) performed in patients over 18 years with ASA-PS of I-III, aimed to assess the efficacy of antiemetics including NK-1 receptor antagonists and 5-HT3 receptor antagonists, and compared the incidence of PONV were included. STUDY APPRAISAL AND SYNTHESIS METHODS: All statistical assessments were conducted by a random effect approach and odds ratios and 95% Confidence Intervals were calculated. RESULTS: Aprepitant 40mg and 80mg significantly reduced the incidence of vomiting 0-24hours postoperatively (Odds Ratio [OR = 0.40]; 95% Confidence Interval [95% CI 0.30-0.54]; p < 0.001, and OR = 0.32; 95% CI 0.19-0.56; p < 0.001). Fosaprepitant could also reduce the incidence of vomiting significantly both 0-24h and 0-48hours postoperatively (OR = 0.07; 95% CI 0.02-0.24; p < 0.001 and OR = 0.07; 95% CI 0.02-0.23; p < 0.001). LIMITATIONS: Risk factors for PONV are not considered, RCTs using multiple antiemetics are included, RCTs for fosaprepitant is small, and some bias may be present. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Aprepitant and fosaprepitant can be effective prophylactic antiemetics for postoperative vomiting. However, more studies are required for higher-quality meta-analyses. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42019120188. SN - 2352-2291 UR - https://www.unboundmedicine.com/medline/citation/32753114/[Neurokinin_1_receptor_antagonists_for_postoperative_nausea_and_vomiting:_a_systematic_review_and_meta_analysis]_ DB - PRIME DP - Unbound Medicine ER -