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Fosaprepitant Does Not Interfere With Commonly Used Intraoperative Neuromonitoring Modalities Under General Anesthesia: A Preliminary Study. Journal of neurosurgical anesthesiology Lopez, J. R., Jaffe, R. A., Lopez, I. R., Burbridge, M. A. 2022

Abstract

BACKGROUND: Fosaprepitant [Emend], a neurokinin type-1 [NK-1] receptor antagonist, is a highly effective for the prophylaxis of postoperative nausea and vomiting [PONV] after general anesthesia; it is particularly effective in patients undergoing neurosurgical procedures. Based on the widespread distribution of NK-1 receptors in the central and peripheral nervous systems, we sought to determine whether fosaprepitant administration would interfere with commonly used intraoperative neurophysiologic monitoring modalities during general anesthesia.METHODS: Eleven patients having propofol-based general anesthesia for interventional neuroradiology procedures were administered 150mg fosaprepitant intravenously after baseline electroencephalogram [EEG], transcranial motor evoked potential [TcMEP], and somatosensory evoked potential [SSEP] recordings were obtained. Recordings of these neuromonitoring modalities at 30, 60, and 90 min after fosaprepitant administration were compared to baseline.RESULTS: Fosaprepitant did not have a significant effect on SSEP/TcMEP amplitudes or latencies, or on TcMEP morphology. There were also no changes in EEG voltage, frequency, or symmetry.CONCLUSION: Fosaprepitant does not appear to markedly interfere with SSEP, TcMEP, or EEG neuromonitoring modalities during propofol-based general anesthesia.

View details for DOI 10.1097/ANA.0000000000000865

View details for PubMedID 36006662