Vascular Pain and Nurse Burden in Peripheral Administration of Fosaprepitant/Fosnetupitant: A Prospective Observational Study.

Background/aim: Vascular pain associated with NK1 receptor antagonists, particularly fosaprepitant, remains a significant challenge in cancer chemotherapy. The present study investigated the incidence of vascular pain with the administration of fosaprepitant and fosnetupitant and assessed the psychological burden on nurses performing venipuncture.

Patients and methods: We conducted a prospective observational study involving 115 cancer patients receiving NK1 receptor antagonists via peripheral venous catheters. Vascular pain was evaluated using a numerical rating scale. Nurses' psychological burden was assessed through questionnaires and a qualitative analysis.

Results: Vascular pain occurred in 19% of 304 venipunctures, and its incidence was significantly lower with fosnetupitant (3.1%) than with fosaprepitant (22.9%) (p<0.01). Switching from fosaprepitant to fosnetupitant reduced pain in all cases. Nurses experienced psychological burden in 97% of venipunctures, with severe distress (NRS ≥3) in 19% of cases. The qualitative analysis revealed that nurses' distress was affected by the vascular status, patient behavior, and concerns about drug administration.

Conclusion: The incidence of vascular pain was lower with fosnetupitant than with fosaprepitant. Nurses experienced significant psychological burden during venipuncture, particularly when patients reported pain. These results suggest that fosnetupitant is a preferable option for reducing both patient discomfort and nurses' psychological burden in chemotherapy administration.