Fosaprepitant Does Not Interfere With Commonly Used Intraoperative Neuromonitoring Modalities Under General Anesthesia: A Preliminary Study.

Abstract

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. 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. 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. Fosaprepitant does not appear to markedly interfere with SSEP, TcMEP, or EEG neuromonitoring modalities during propofol-based general anesthesia.