Preoperative Aprepitant to Improve Same-Day Discharge After Total Knee Arthroplasty: A Randomized Double-Blind Placebo-Controlled Trial
Endeavor Health
Summary
The purpose of this research is to study whether adding an FDA approved medication called aprepitant (a medication given to patients like you to reduce or eliminate nausea and vomiting) to the usual treatment to prevent nausea and vomiting given to patients during knee replacement surgery helps more patients go home on the same day of surgery (before midnight) by eliminating nausea and vomiting.
Description
This is a prospective, randomized, double-blind, placebo-controlled trial involving adults undergoing primary total knee arthroplasties at Endeavor Health SKH with presumed same-day discharge (as identified by the orthopedic surgery team prior to surgery). Patients will be randomly assigned to either receive 32 mg of intravenous (IV) preoperative aprepitant, in addition to the standard antiemetic protocol (4 mg IV dexamethasone after induction of MAC sedation anesthesia and 4 mg IV ondansetron at surgical closure), or the standard protocol with placebo (saline solution in same volume at the ti…
Eligibility
- Age range
- 18–90 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Receiving primary, unilateral elective TKA with or without abductor canal block * Asa I-III * Age 18-90 * Ability to receive ondansetron and dexamethasone * Ability to consent and complete surveys * English or Spanish speaking * Receiving regional anesthesia (epidural or spinal) for surgery Exclusion Criteria: * Allergy to any of the anti-emetics being administered * Current treatment of pimozide * Emergent surgery * Revision/ multiple revisions of TKA * Clinical suspicion of possible bowel obstruction * Need for general anesthesia * Pregnant/breast feeding * AST\> 2.5…
Interventions
- DrugAprepitant Injection
32mg aprepitant will be administered intravenously preoperatively during single sided total knee arthroscopy
- DrugOndansetron (Zofran)
4 mg IV ondansetron will be given at surgical closure during total knee arthroscopy
- DrugDexamethasone
4 mg IV dexamethasone will be given after induction of MAC sedation anesthesia during total knee arthroscopy
- OtherPlacebo
Patients will receive 32 mg of intravenous (IV) placebo preoperatively for a total knee arthroscopy
Location
- Endeavor Health Skokie HospitalSkokie, Illinois