Date of this Version

11-28-2023

Document Type

DNP Project

Abstract

Background: Postoperative nausea and vomiting (PONV) remains one of the most common patient complaints after surgery, contributing to decrease patient satisfaction, delayed recovery, and an economic burden on healthcare organizations. PONV has been shown to cost an ambulatory center $ 0.25 million to $1.5 million in lost revenue. Despite improved anesthesia care and guidelines, PONV rates remain high.PONV pathophysiology is multifactorial. The use of a sole antiemetic agent is inadequate; therefore, requiring a combination of antiemetics to antagonize multiple receptors to provide optimal prophylaxis.

Objective: This project aimed to compare the effectiveness of the amisulpride compared to aprepitant in decreasing the incidence of PONV in adult patients undergoing general surgery and to enhance the knowledge and attitude of anesthesia providers regarding the utilization of amisulpride in combination with other antiemetics as part of a multimodal treatment modality for PONV prophylaxis.

Method: A literature review was conducted comparing amisulpride and aprepitant as prophylactic agents for PONV. The findings were presented as an educational module to anesthesia providers, and a pre- and post-survey were given to evaluate both baseline knowledge and the degree of knowledge gained. The primary setting for this educational module was a level-one trauma center in South Florida. An anonymous online platform was utilized to access the surveys and store data collection.

Results: Ten high-level research articles selected for appraisal and inclusion of a literature review on amisulpride and aprepitant as prophylactic agents for PONV. Amisulpride was found to be an effective antiemetic with a high safety profile.

Conclusion: The educational module was efficacious in improving the anesthesia providers’ knowledge on amisulpride as a prophylactic agent for reducing the incidence of PONV. Additionally, the module positively influenced the providers’ inclination and attitude towards incorporating the use of amisulpride into their clinical practice.

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