Comparison of Oral Aprepitant and Transdermal Scopolamine for Preventing Postoperative Nausea and Vomiting

A Randomized, Double-blind Comparison of Oral Aprepitant Alone Versus Oral Aprepitant and Transdermal Scopolamine for Preventing Postoperative Nausea and Vomiting

Recent evidence suggests multiple drug therapy is superior to single agents. The 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 with or without transdermal scopolamine preoperatively.

Study Overview

Status

Completed

Conditions

Detailed Description

Postoperative nausea and vomiting (PONV) is a serious problem complicating surgery. PONV has an overall incidence of 30% and a 70% incidence in high-risk patients. PONV yields unplanned hospital admission, pulmonary aspiration, esophageal rupture, electrolyte abnormalities, dehydration, and delayed discharge from the postanesthesia care unit (PACU). Additional use of resources costs the health care industry hundreds of millions of dollars annually. Patient satisfaction is greatly improved when PONV is prevented.4 PONV etiology is multifactorial and the treatment is multimodal.

Study Type

Interventional

Enrollment (Actual)

115

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Pennsylvania
      • Philadelphia, Pennsylvania, United States, 19102
        • Hahnemann University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patient must be between 18 and 65 years of age.
  • Patient's ASA (American Society of Anesthesiologist) class must be between 1 and 3.
  • If patient is currently on oral contraceptive to prevent pregnancy, she must be willing to use a back up form of birth control for one month post study.
  • Patient must have 1 FACTOR to qualify

    • Female Sex
    • History of PONV
    • Motion Sickness
    • Non-Smoker
    • Intended Use of Post Operative Opioids

Exclusion Criteria:

  • Patients with a history of vomiting due to middle ear infection, nervous system disorder, or any other condition.
  • The surgical procedure is less than 1 hour.
  • The patient is pregnant or breast feeding.
  • The patient has taken antiemetic medication in previous 24 hours.
  • Patients with narrow-angle glaucoma.
  • Allergy to belladonna alkaloids.
  • Hypersensitivity to barbiturates.
  • Patient taking any of the following medications:

    • Orap
    • Seldane
    • Hismanal
    • Propulsid
    • Phenytoin
    • Phenothiazines
    • Tricyclic Antidepressants
    • Meperidine
    • Tolbutamide
    • Aluminum and Magnesium Trisilicate-containing Antacids
    • Anti-Cholinergics
    • Coumadin
  • Male patients with prostate hypertrophy.
  • Patients with severe hepatic disease.
  • Patients on Chemotherapy and taking Aprepitant.
  • Patients with fever.
  • Patients with sepsis.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Aprepitant

Oral Aprepitant pill and placebo transdermal patch at least 1 hour prior to surgical procedure.

Emend (Aprepitant) + Placebo

40mg tablet
Other Names:
  • Emend (Aprepitant) + Placebo
Active Comparator: Scopolamine
Oral Aprepitant pill and Scopolamine transdermal patch at least 1 hour prior to surgical procedure.
1.5 mg patch delivering transdermally in vivo approx. 1.0mg over 3 days
Other Names:
  • Scopolamine + Emend (Aprepitant)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Number of Participants With Postoperative Nausea and Vomiting
Time Frame: 0-24 hours
0-24 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Collaborators

Investigators

  • Study Director: Jay Horrow, MD, Drexel University College of Medicine

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2008

Primary Completion (Actual)

March 1, 2010

Study Completion (Actual)

March 1, 2010

Study Registration Dates

First Submitted

April 8, 2008

First Submitted That Met QC Criteria

April 14, 2008

First Posted (Estimate)

April 16, 2008

Study Record Updates

Last Update Posted (Estimate)

May 15, 2014

Last Update Submitted That Met QC Criteria

May 1, 2014

Last Verified

September 1, 2013

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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