Background and Goal of Study: 
Palonosetron is 3rd generation of 5-HT 3  antagonist, 
which has unique mechanism compared with other 5-
HT3  antagonists. Aprepitant is a selective NK1 receptor antagonist, which has demons trated efficacy against 
postoperative nausea and vomiting (PONV) in combina
tion with ondansetron or ramosetron.[1, 2] However, there is no report about  the effect of aprepitant combined 
with palonosetron for the prevention of PONV. The a
im of this study was to evaluate the effect of combination of aprepitant and palonosetron compared to palonosetron alone for the prevention of PONV in female patients receiving intravenous patient-controlled analgesia (IV-PCA) using fentanyl. 
Materials and Methods: 
In this randomized study, 100 female patient scheduled elective surgery under general anesthesia were 
investigated. Patients were randomly allocated to r
eceive 80mg of aprepitant P.O. (AP group, n=50) or none (P group, n=50) 2-3 hours before the operation. All patients received 0.075 mg of palonosetron after induction of anesthesia. The incidence of nausea and vomiting, severity of nausea, and the use of rescue drugs were evaluated for 24 hours after operation. 
Results and Discussion: 
The incidences of nausea (55%), vomiting (1%) in the AP group were not different significantly compared with that of nausea (48%), vomiting (14%) in the P group during 24 hours after surgery.
 The patient required rescue drugs in the AP group (31%) was similar compared with P group (32%) during 24 hours after surgery.   
Conclusion(s): 
The aprepitant combined with palonosetrone did not 
reduce the incidence of PONV compared to alonosetrone alone during the 24 h after operation in woman patients receiving IV-PCA using fentanyl. 
References: 
1. Vallejo MC,et al.  Plast Reconstr Surg. 2012;129:519-26. 
2.. Lee SJ, et al.Korean J Anesthesiol. 2012; 63:221-6.

The effect of aprepitant combined with palonosetron for the prevention of postoperative nausea and vomiting in women patients using intravenous patient-controlled analgesia: aprepitant plus palonosetron vs palonosetron alone