Abstract
Background and Aim: Postoperative nausea and vomiting (PONV) is commonly seen after laparoscopic surgery. In this randomized double blind prospective clinical study, we investigated and compared the efficacy of palonosetron with dexamethasone and ondensetron with dexamethasone to prevent postoperative nausea and vomiting after laparoscopic cholecystectomy.
Materials and Method: Sixty patients (18-60 yrs of age) undergoing elective laparoscopic cholecystectomy were randomly allocated one of the two groups containing 30 patients each. Group 1 received ondensetron 4 mg and dexamethasone 8 mg intravenously as a bolus before induction of anaesthesia. Group 2 received palonosetron 0.075 mg and dexamethasone 8 mg intravenously as a bolus before induction.
Result: The incidence of a complete response (no PONV, no rescue medication) during post operative period is 86.6%,86.6%,93.4% and 93.4% in palonosetron group in 0-4,4-12,12-24 and 24-48 hrs respectively in comparison to ondensetron group in which 50%,63.34%,90% and 93.3%.
Conclusion: Prophylactic therapy with palonosetron is more effective than ondensetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy.
Keywords: Palonosetron, Ondensetron, Postoperative Nausea and Vomiting (PONV), Laparoscopic surgery.
References
- Paech Muchatuta NA and MJ: Management of post operative nausea vomiting:focus on Palanosetron; Ther Clin Risk Manag. 2009 feb; 5 (1): 21-34
- Dundee JW, Chestnutt, Ghaly RG,Lyans AG.Traditioal Chinese acupuncture : a potentially useful antiemetic?Br Med J (clin Res Ed) 1986;293:583-584.
- LeeA,Fan LT. Stimulation of the wrist acupuncture point p6 for preventing postoperative nausea and vomiting. Cochare Database Syst Rev.2009;(2): CD003281.
- Khalil S, Philbrook L, Rabb M, et al. Ondansetron and Promethazine combination or promethazine alone reduces nausea and vomiting after middle ear surgery: J Clin Anesth, 1999; 11: 596-600.
- Fujii Y, Toyooka H, Tanaka H: Prophylactic anti-emetic therapy with Granisetron, Droperidol and Metoclopramide in female patients undergoing middle ear surgery: Anaesthesia,1998; 53: 1165-8.
- Fujii Y, Tanaka H, Kobayashi N: Prevention of postoperative nausea and vomiting with antiemetics in patients undergoing middle ear surgery: comparison of a small dose of Propofol with Droperidol or Metoclopramide:Arch Otolaryngol Head Neck Surg, 2001; 127:25-8.
- Henzi I, Walder B, Tramer MR: Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review: Anesth Analg, 2000; 99: 186-94.
- Bunce KT, Tyers MB: The role of 5-HT3 in postoperative nausea and vomiting: Br J Anaesth, 1992; 69: 60S-62S.
- EIDI M khaosro kolahdouzan Hamesh Hosseinzadeh and Tabaqi R. Compared of preoperative Ondensetron and Dexamethasone in the prevention of Post- tympanoplasty Nausea and vomiting.Iran J Med sci September 2012; Vol37 No 3.
- Berrin Isik,Nedim Cekmen,Mustafa Arslan, Ozgur Ozsoylar, Aysegul Z.Kordan,Mehmet Akcabay compared the antiemetic effect of Ondensetron and Dexamethasone on middle ear surgery. Saudi Med J 2006; Vol. 27(5):646-651
- SK Park and EJ CHO compared Palonosetron with Ondensetron in preventing postoperative nausea and vomiting after gynaecological laproscopic surgery the Journal ofminternational medical research 2011;39:399-407
- Chakravarty N. and Raghuvanshi S.K. studied efficacy of Palonosetron and Ondensetron in post operative nausea vomiting in middle ear surgery.Int J Bio Sci 2013oct;4(4) (B) 67-74.
- Ho KY, Gan TJ. Pharmacology, pharmacogenetics, and clinical efficacy of 5-hydroxytryptamine type 3 receptor antagonists for postoperative nausea and vomiting.CurrOpinAnaesthesiol 2006;19:606-11.
- Muchatuta NA, Paech MJ. Management of postoperative nausea and vomiting: focus on palonosetron. TherClin Risk Manage 2009;5:21-34.
- Candiotti KA, Kovac AL, Melson TI, Clerici G, JooGan T. A randomized, double-blind study to evaluate the efficacy and safety of three different doses of palonosetron versus placebo for preventing postoperative nausea and vomiting.AnesthAnalg 2008;107:445-51.
- Kovac AL: Prevention and treatment of postoperative nausea and vomiting. Drugs 2000; 59: 213 - 243.
- Tramer MR, Reynolds DJ, Moore RA, McQuay HJ. Efficacy, dose-response, and safety of ondansetron in prevention of postoperative nausea and vomiting: a quantitative systematic review of randomized placebo controlled trials. Anesthesiology1997; 87: 1277 -1289.
- Andrews PLR, Hawthorn J. The neurophysiology of vomiting.Clinical Gastroenterology 1988; 2: 141-168.
- Vance JP, Neill RS , Norris W. The incidence and aetiology of postoperative nausea and vomiting in a plastic surgical unit; BritishOf Plastic Surgery 1973; 26:336-339.
- Stein JM. Factors affecting nausea and vomiting in a plastic surgery patient.Plast Reconstruct Surg 1982; 70:505-11.
Corresponding Author
Anita Pareek
4-E-183, JNV Colony, Bikaner, Rajasthan
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.91
