Ninety-seven percent of bariatric surgery patients avoided post-operative nausea and vomiting (PONV) with the addition of a second drug to the standard treatment given during surgery.
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An estimated 113,000 people in the United States have bariatric weight-loss surgery annually, according to the American Journal of Surgery. Approximately 15 million, or one in 50 American adults, are morbidly obese, which is associated with more than 30 diseases and conditions, including type 2 diabetes, heart disease, obstructive sleep apnea, hypertension, asthma, cancer, osteoarthritis and infertility. The direct and indirect costs to the health care system associated with obesity are about $147 billion annually, according to the American Society for Metabolic and Bariatric Surgery. These costs are expected to increase to $344 billion in five years, if obesity rates continue to increase at the current pace.
The study included 124 patients. Within one hour of the anticipated start of anesthesia, 64 people received the combination treatment of Zofran (the standard therapy) plus aprepitant; the remaining 60 patients got the Zofran and a placebo. Nausea was assessed with a 10-point scale after surgery at intervals of 30 minutes, one, two, six, 24 , 48 and 72 hours.
The study found that only three percent of patients who received the combination treatment experienced PONV. The incidence of vomiting was 15 percent in the placebo group who received Zofran alone.
"This multi-drug therapy can benefit patients at higher risk for PONV," continued Dr. Sinha. "There are multiple receptors in the brain stem that trigger vomiting; if we use the combination therapy, we can increase the number of receptors blocked and lower the incidence of vomiting."
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