Aprepitant Versus Ondansetron in Preoperative Triple-therapy Treatment of Nausea and Vomiting
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Purpose
This study is being done to determine the efficacies of two preventative drug combinations for postoperative nausea and vomiting in patients undergoing neurosurgery. The aim of this study is to compare the efficacy of using aprepitant instead of ondansetron in combination with dexamethasone and promethazine for post-operative nausea and vomiting prophylaxis. By completing this comparison study investigators will determine the most efficacious drug combination which will allow us to enhance the overall comfort and satisfaction of neurosurgical patients in the immediate postoperative period.
| Condition | Intervention | Phase |
|---|---|---|
|
PONV Nausea |
Drug: Aprepitant Drug: Ondansetron Drug: Promethazine Drug: Dexamethasone |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Aprepitant Versus Ondansetron in Preoperative Triple-therapy Treatment of Nausea and Vomiting |
- PONV scores on a verbal response scale [ Time Frame: 24 hours post operatively ] [ Designated as safety issue: No ]
To assess the efficacy of triple therapy with Scopolamine, Ondansetron and Dexamethasone for prevention of post operative nausea and vomiting in high risk patients during the first 24 hours after neurological surgery under general anesthesia.
- Proportion of patients with a complete response/complete control during the first 24 hours after neurological surgery under general anesthesia
- Assess the severity of nausea and vomiting during the first 24 hours after neurological surgery.
- PONV scores on a verbal response scale [ Time Frame: 72 hours post-operatively ] [ Designated as safety issue: No ]
To assess the efficacy of triple therapy with Scopolamine, Ondansetron and Dexamethasone for prevention of post operate nausea and vomiting in high risk patients during a delayed period after neurological surgery under general anesthesia.
- Proportion of patients with a complete response/complete control during the first 24 hours after neurological surgery under general anesthesia.
- Assess the severity of nausea and vomiting during the first 24 hours after neurological surgery.
| Estimated Enrollment: | 200 |
| Study Start Date: | June 2007 |
| Estimated Study Completion Date: | December 2012 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Aprepitant
Aprepitant is given orally, along with an oral or PO placebo depending on their group assignment for uniformity. Each patient will receive three drugs in their respective triple prophylactic medication plus an IV or oral placebo prior to induction of anesthesia. Triple therapy 40mg Aprepitant PO + IV placebo, 25mg Promethazine IV and 10mg dexamethasone IV |
Drug: Aprepitant
Subject will receive 40 mg of Aprepitant versus placebo PO before anesthesia induction
Other Name: Emend
Drug: Promethazine
Subject will receive 25 mg of Promethazine IV around anesthesia induction
Other Names:
Drug: Dexamethasone
Subject will receive 10 mg of Dexamethasone IV around anesthesia induction
Other Names:
|
|
Active Comparator: Ondansetron
Ondansetron is given via IV, along with an oral or IV placebo depending on their group assignment for uniformity. Each patient will receive three drugs in their respective triple prophylactic medication (25mg promethazine, 10mg dexamethasone, and either 4mg ondansetron or 40mg aprepitant) plus an IV or oral placebo prior to induction of anesthesia. Triple therapy 4mg Ondansetron IV + PO placebo, 25mg Promethazine IV and 10mg dexamethasone IV |
Drug: Ondansetron
Subject will receive 4 mg of Ondansetron IV versus placebo around anesthesia induction
Other Name: Zofran
Drug: Promethazine
Subject will receive 25 mg of Promethazine IV around anesthesia induction
Other Names:
Drug: Dexamethasone
Subject will receive 10 mg of Dexamethasone IV around anesthesia induction
Other Names:
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Adult patients
- 18 to 85 years of age
- Scheduled for neurosurgery requiring opening of the cranium and dura at Ohio State University Medical Center and who consent in writing to participate in this study are eligible.
Exclusion Criteria:
Patients will be excluded from this study if they are
- prisoners
- pregnant women
- mentally ill
- under the age of 18 or over the age of 85
- ASA classification V
- alcohol or drug abusers
- have a cerebral perfusion pressure (CPP) greater than 150 mmHg or less than 50 mmHg.
Contacts and Locations| Contact: Alberto A Uribe, M.D. | 614-293-3559 | Alberto.Uribe@osumc.edu |
| Contact: Andrew Otey, B.S. | 614-293-3559 |
| United States, Ohio | |
| The Ohio State University Wexner Medical Center | Recruiting |
| Columbus, Ohio, United States, 43210 | |
| Principal Investigator: | Sergio D Bergese, M.D. | Ohio State University |
More Information
No publications provided
| Responsible Party: | Sergio Bergese, Associate Professor, The Ohio State University |
| ClinicalTrials.gov Identifier: | NCT01474915 History of Changes |
| Other Study ID Numbers: | 2007H0053 |
| Study First Received: | November 8, 2011 |
| Last Updated: | September 25, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Ohio State University:
|
Neurosurgery |
Additional relevant MeSH terms:
|
Nausea Vomiting Signs and Symptoms, Digestive Signs and Symptoms Promethazine Ondansetron Diphenhydramine Dexamethasone Aprepitant Dexamethasone acetate Dexamethasone 21-phosphate BB 1101 Antipruritics Dermatologic Agents Therapeutic Uses |
Pharmacologic Actions Histamine H1 Antagonists Histamine Antagonists Histamine Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs Anti-Allergic Agents Antiemetics Autonomic Agents Peripheral Nervous System Agents Central Nervous System Agents Gastrointestinal Agents Hypnotics and Sedatives Central Nervous System Depressants |
ClinicalTrials.gov processed this record on June 17, 2013