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Enhanced recovery protocols and PONV management guidelines are now centered on the assessment of the individual patient's risk for developing PONV, as well as multimodal prophylaxis using antiemetics targeting different mechanisms of action. Over the last two decades, the neurokinin\u20101 receptor (NK1R) has emerged as a therapeutic target for the management of PONV. This review of the literature explains the role of the NK1R and its ligand\u2014substance P\u2014in vomiting, describes the pharmacologic and pharmacokinetic properties of NK1R antagonists (NK1RAs) and summarizes the clinical evidence supporting NK1RAs for PONV prophylaxis in patients undergoing surgery. In particular, we discuss the therapeutic application of NK1RA in PONV prophylaxis protocols owing to their advantages over other antiemetic classes in efficacy, duration of efficacy, safety, pharmacology, and ease of administration. Future studies will be aimed at further investigating the efficacy and safety of NK1RA\u2010based multimodal combinations, particularly among vulnerable populations (e.g., children and elderly).<\/jats:p>","DOI":"10.1002\/phar.2814","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T10:58:48Z","timestamp":1683802728000},"page":"922-934","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Neurokinin\u20101 receptor antagonists for the prevention of postoperative nausea and vomiting"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3342-493X","authenticated-orcid":false,"given":"Tricia A.","family":"Meyer","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Texas A&amp;M College of Medicine  Temple Texas 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