Kristin Mccoy, MD, Meaghan Broderick, MD, James Bonheur, MD, Phillip Bilderback, MD. Stamford Hospital
Introduction: Laparoscopic sleeve gastrectomy was first performed in 2000 as a component of the biliopancreatic diversion with duodenal switch. Today, it is gaining popularity in the bariatric field as a stand-alone procedure for weight loss. However, patients continue to complain of postoperative nausea, vomiting and dry heaving due to the new anatomical constriction. Nausea and vomiting can be harmful to the newly formed staple line. Several anti-emetics are utilized in the postoperative patients. We aim to investigate the use of arepitant which is a neurokinin-1 inhibitor as a prophylactic anti-emetic in laparoscopic sleeve gastrectomy patients.
Methods: 36 patients from a multicenter bariatric practice were studied prospectively between October 2017- Septmeber 2018. Patient data collected included age, gender, BMI, post-operative use of anti-emetic medicine, episodes of emesis, and length of stay. Statistical analysis was performed on post-operative episodes of emesis, and administered doses of antiemetic medicine.
Results: There were 18 patients in each of the cohorts. The population was predominantly female with only one male in each of the cohorts. The average age in the arepitant group was 41.6 vs. 43.2 in the control group. Average starting body mass index (BMI) in the arepitant group was 41.9 vs. 41.0 in the control group. There was no statistical difference in BMI or age. The arepitant group required less post-operative emetics with 7.6 mg of Zofran administered in the arepitant group and 9.6 mg in the control group. The length of stay was also shorter in the arepitant group as compared to the control group (1.55 days vs. 1.73 days). There was no significant difference in number of episodes of emesis between the arepitant and control arms.
Conclusion: The preoperative use of arepitant aids in reducing the postoperative nausea and vomiting patients experience. Our results show promise in decreasing the length of stay in laparoscopic sleeve gastrectomy patients, as well as the amount of post-operative anti-emetics required. Arepitant should be considered in the use of bariatric elective procedures.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94695
Program Number: P122
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster