The safety and efficacy of NEPA in preventing postoperative nausea and vomiting after general anesthesia during gastrointestinal cancer surgery: a single-center retrospective study.

Background: Postoperative nausea and vomiting (PONV) are common complications after gastrointestinal (GI) tumor surgery under general anesthesia that hinder recovery. This retrospective study, conducted from May to September 2023 at Tianjin Cancer Hospital Airport Hospital, aimed to evaluate the safety and efficacy of netupitant and palonosetron (NEPA) in reducing PONV in such patients.

Methods: All patients received one NEPA capsule orally the evening before surgery. PONV symptoms, including nausea, vomiting, pain, abdominal discomfort, and satiety, were monitored for 72 hours postoperatively via daily visual analog scale (VAS) score assessment.

Results: We initially included 50 patients; 45 patients (32 males, 13 females) met the inclusion criteria, with an average body mass index (BMI) of 23.2±4.2 kg/m² and a mean weight of 66.2±13.2 kg. Within the first 24 hours post-surgery, 6 (14%) patients experienced vomiting, with 20% of these patients having a VAS score above 4; this proportion was 13% within 24-48 hours and decreased to only 4% within 48-72 hours. No vomiting was documented in the 48-72-hour postoperative period, and the incidence of vomiting in patients treated with NEPA was significantly lower than the guideline incidence.

Conclusions: NEPA demonstrated high efficacy and convenience, with vomiting occurring in only 15% of patients and nausea in 40% within 72 hours after surgery and more patients showed a trend toward a favorable response over time. NEPA has proven to be a safe, effective, and convenient option for preventing PONV in GI cancer surgeries.