A Prospective Single Blind Randomized Study on Prevention of Postoperative Nausea and Vomiting with Palanosetron versus Ondansetron in Patients undergoing Laparoscopic Surgery
Swarnalingam Thangavelu1, Nazir Ahmed Mallick2, Anu Karthiga Manoharan3
1Associate Professor, 2Professor & HOD, 3Resident, Department of Anaesthesiology, Tagore Medical College & Hospital, Affiliated with TN Dr. M.G.R Medical University, Chennai- 600127, Tamilnadu, India.
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Context: In the modern era of surgical field laparoscopic surgeries are more frequently performed than open surgeries. Postoperative nausea and vomiting is a common complaint encountered in the patients who have undergone laparoscopic surgeries because of pneumoperitoneum created by CO2. A number of anti-emetics are given as prophylactic agents to prevent postoperative nausea and vomiting. Among them 5-hydroxytrypatmine type 3 receptor antagonists are highly effective in prevention and treatment of PONV. With this background we conducted a study for evaluating the effectiveness of two 5-HT3 receptor antagonists in prevention of PONV in patients undergoing laparoscopic surgeries under general anesthesia. Aim: To compare the efficacy and safety profile of two 5 HT3 antagonists namely palonosetron and ondansetron in the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgeries. Settings & Design: This was a prospective, randomized, single-blind comparative study. Sixty patients of age group between 18-60 years of Ameri can Society of Anaesthesiologists physical status class I and II undergoing laparoscopic surgeries were enrolled. They were randomly allocated into two groups namely Group A and B with 30 patients in each group. Group A received 0.075mg of injection palonosetron and Group B received 4mg of injection ondansetron intravenously 30 minutes before induction of anaesthesia. Statistical Analysis used: Statistical work up was performed using the SPSS version 16. Student’s t –test was used for quantitative data and Chi- square test was used for qualitative data. P value of less than 0.05 was found to be statistically significant. Results: The incidence of PONV in group A (palonosetron) was found to be 13% which is lesser than group B (ondansetron) where the incidence was 23%. The need for rescue antiemetic was also comparatively lesser in group A than group B. (23% vs 51%). The number of complete responders were 26 (86%) and 23 (76%) for palonosetron and ondansetron respectively. Conclusion: Palonosetron is effective antiemetic for preventing PONV during the late postoperative period while compared to ondansetron.
Keywords : Palonosetron; Ondansetron; Postoperative Nausea and Vomiting; Laparascopy.
Corresponding Author : Thangavelu Swarnalingam, 45/F2 Sai Krupa Homes, Ganapathi Nagar 3rd Street, Urapakkam, Kancheepuram, Tamilnadu-603210, India.