{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T22:55:20Z","timestamp":1772060120551,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T00:00:00Z","timestamp":1651276800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anesthesiology Research and Practice"],"published-print":{"date-parts":[[2022,4,30]]},"abstract":"<jats:p>Background. Coadministration of different antiemetics proved to decrease postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG). This trial compared aprepitant\/dexamethasone (A\/D) combination vs mirtazapine\/dexamethasone (M\/D) combination vs dexamethasone (D) alone for prevention of PONV in morbidly obese patients undergoing LSG. Methods. Ninety patients scheduled for LSG were randomly allocated to receive 8\u2009mg dexamethasone intravenous infusion (IVI) only in the D group or in addition to 80\u2009mg aprepitant capsule in the A\/D group or in addition to 30\u2009mg mirtazapine tablet in the M\/D group. Assessment of PONV was carried out at 0\u20132\u2009h (early) and 2\u201324\u2009h (late). The primary outcome was the complete response 0\u201024 h after surgery. Collective PONV, postoperative pain, side effects and patient satisfaction score were considered as secondary outcomes. Results. The A\/D and M\/D groups were superior to the D group for a complete response within 0\u201324\u2009h after surgery (79.3% for the A\/D group, 78.6% for the M\/D group, and 20.7% for the D group). The D group was inferior to the A\/D and M\/D groups regarding collective PONV and use of rescue antiemetic 0\u201324\u2009h after surgery (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>, <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.001<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>, respectively). The peak nausea scores (2\u201324\u2009h) were significantly reduced in the M\/D group in comparison to the D group (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.005<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>). Patients in the M\/D group showed high sedation scores, while those in the A\/D group showed low pain scores (2\u201324\u2009h) and less analgesic requirements (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>&lt;<\/g:mo>\n                        <g:mn>0.001<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>, <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>P<\/i:mi>\n                        <i:mo>&lt;<\/i:mo>\n                        <i:mn>0.001<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>, <jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>P<\/k:mi>\n                        <k:mo>&lt;<\/k:mo>\n                        <k:mn>0.001<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>, respectively). The A\/D and M\/D groups were superior to the D group with regard to the patient satisfaction score (<jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>P<\/m:mi>\n                        <m:mo>&lt;<\/m:mo>\n                        <m:mn>0.001<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>). Conclusion. Aprepitant\/dexamethasone combination and mirtazapine\/dexamethasone combination were superior to dexamethasone alone in alleviating postoperative nausea and vomiting in morbidly obese patients scheduled to undergo laparoscopic sleeve gastrectomy. Trial Registration: ClinicalTrials.gov identifier: NCT04013386.<\/jats:p>","DOI":"10.1155\/2022\/3541073","type":"journal-article","created":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T20:05:08Z","timestamp":1651349108000},"page":"1-10","source":"Crossref","is-referenced-by-count":3,"title":["A Randomized Controlled Trial for Prevention of Postoperative Nausea and Vomiting after Laparoscopic Sleeve Gastrectomy: Aprepitant\/Dexamethasone vs. Mirtazapine\/Dexamethasone"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0289-8101","authenticated-orcid":true,"given":"Tarek M.","family":"Ashoor","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain-Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7641-3934","authenticated-orcid":true,"given":"Dina Y.","family":"Kassim","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3456-0471","authenticated-orcid":true,"given":"Ibrahim M.","family":"Esmat","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain-Shams University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2014.0639"},{"key":"2","first-page":"90","article-title":"Postoperative nausea and vomiting in bariatric surgery in comparison to non-bariatric gastric surgery","volume":"14","author":"J. 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