An estimated 113,000 people in the United States undergo weight loss surgery each year, according to the American Journal of Surgery. Although the procedures are very safe, any operation will have potential negative side effects. One side effect that some patients experience is nausea or vomiting after a bariatric procedure, often a result of general anesthesia. Because the stomach is transformed during some weight loss surgeries, vomiting can be dangerous as it risks rupturing the fresh staple lines on the stomach. Reducing the risk of this side effect would mean more comfortable patients as well as safer surgery and anesthesia. Currently, surgeons often give patients an anti-nausea medication called Zofran to combat the nausea. While this often works well, it does not eliminate symptoms in all patients. Recently though, researchers found that adding another drug to the regimen tends to reduce post-operative nausea and vomiting.
Researchers wanted to assess whether another drug – aprepitant (Emend) – could be combined with Zofran to provide greater nausea relief. The study involved 124 weight loss surgery patients. Within one hour of the anticipated start of anesthesia, 64 people received the combination treatment of Zofran plus aprepitant, and 60 patients received the Zofran and a placebo. After surgery at intervals of 30 minutes, one, two, six, 24 , 48 and 72 hours, nausea was assessed with a 10-point scale. The key finding was that only three percent of patients who received the combination treatment experienced post-operative nausea or vomiting. In the placebo group who received Zofran alone, the incidence of vomiting was 15 percent.
Study author Dr. Ashish Sinha, vice chair of anesthesiology and perioperative medicine at Drexel University College of Medicine in Philadelphia, said “this multi-drug therapy can benefit patients at higher risk for vomiting. There are multiple receptors in the brain stem that trigger vomiting, and if we use the combination therapy, we can increase the number of receptors blocked and lower the incidence of vomiting.”
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