Oral Aprepitant and Lower Dose Dexamethasone Versus Aprepitant Alone for Preventing Postoperative Nausea and Vomiting (PONV) After Elective Laparoscopic Surgeries

NCT ID: NCT00835965

Last Updated: 2009-02-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-02-28

Brief Summary

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The combination of aprepitant and lower dose dexamethasone is superior to aprepitant alone with respect to the proportion of patients with a complete response (no vomiting and no use of rescue therapy) during 24 hours after the placement of last suture/staple.

Detailed Description

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Postoperative Nausea and Vomiting (PONV) is a serious and common (50%-70%) complication of laparoscopic abdominal surgery. PONV is multifactorial, and the treatment is multimodal. Preoperative treatment should target the specific mechanism of PONV to minimize its incidence/consequences to the benefit of the patients.

Aprepitant, a selective antagonist of neurokinin-1 (NK-1) receptors, blocks the emetic effects of substance P.5 Substance P action on the NK-1 receptors in the central nervous system (CNS) is one of the final pathways to an emetic response. Dexamethasone is an inexpensive and effective antiemetic drug with minimal side effects after a single-dose administration. The commonly used minimal effective dose is 8 to 10 mg, but the dose 5 mg is suggested for PONV in patients undergoing laparoscopic surgeries. Based on the literature review, occurrence of PONV does not significantly differ at dosing of Dexamethasone equal or higher than 4 mg.

This study compares the incidence of nausea, vomiting, need for rescue medication, prolonged PACU time, and unplanned hospital admission in patients with high risk for PONV treated with oral aprepitant and dexamethasone or aprepitant alone preoperatively.

Conditions

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Nausea Vomiting

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Caregivers Investigators

Study Groups

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Active Comparator

Patients receive aprepitant and dexamethasone for prevention of postoperative nausea and vomiting

Group Type ACTIVE_COMPARATOR

Dexamethasone

Intervention Type DRUG

Dexamethasone 5 mg administered intravenously following endotracheal intubation

Aprepitant

Intervention Type DRUG

Aprepitant 40mg PO one time at least one hour prior to induction of anesthesia

Placebo Comparator

Patients receiving aprepitant and placebo dexamethasone for prevention of postoperative nausea and vomiting

Group Type PLACEBO_COMPARATOR

Aprepitant

Intervention Type DRUG

Aprepitant 40mg PO one time at least one hour prior to induction of anesthesia

Placebo Dexamethasone

Intervention Type DRUG

Interventions

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Dexamethasone

Dexamethasone 5 mg administered intravenously following endotracheal intubation

Intervention Type DRUG

Aprepitant

Aprepitant 40mg PO one time at least one hour prior to induction of anesthesia

Intervention Type DRUG

Placebo Dexamethasone

Intervention Type DRUG

Other Intervention Names

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EMEND EMEND

Eligibility Criteria

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Inclusion Criteria

* at least 18 years old
* ASA physical status I-III
* must have at least 2 risk factors for PONV

Exclusion Criteria

* pregnant or breast feeding patients
* antiemetic medication in previous 24 hours
* allergy or other contraindication to study medications
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role collaborator

Drexel University College of Medicine

OTHER

Sponsor Role collaborator

Main Line Health

OTHER

Sponsor Role lead

Responsible Party

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Main Line Health System, Lankenau Hospital

Principal Investigators

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Dmitri Chamchad, MD

Role: PRINCIPAL_INVESTIGATOR

Lankenau Hospital, Lankenau Institute for Medical Research

Locations

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Lankenau Hospital

Wynnewood, Pennsylvania, United States

Site Status

Countries

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United States

Central Contacts

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Dmitri Chamchad, MD

Role: CONTACT

610-645-6866

Mikhail Medved, PhD

Role: CONTACT

610-645-6866

Other Identifiers

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Merck #32589

Identifier Type: -

Identifier Source: secondary_id

Merck-Chamchad-2008

Identifier Type: -

Identifier Source: org_study_id

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