A COMPARISON OF INTRAVENOUS ONDANSETRON AND PALONOSETRON IN PREVENTING POST-OPERATIVE NAUSEA AND VOMITING AFTER LAPAROSCOPIC CHOLECYSTECTOMY - A RANDOMIZED DOUBLE-BLIND STUDY

Authors

  • Ajay Kumar Department of Anaesthesiology and Critical Care, Deen Dayal Upadhyay Hospital, New Delhi, India. http://orcid.org/0000-0001-9703-3893
  • Sumita Adhana Department of Anaesthesiology and Critical Care, Deen Dayal Upadhyay Hospital, New Delhi, India.
  • Puneet Dwivedi Department of Anaesthesiology and Critical Care, Deen Dayal Upadhyay Hospital, New Delhi, India.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i12.27712

Keywords:

Palonosetron, Ondansetron, Post-operative nausea and vomiting, Laparoscopy, Cholecystectomy

Abstract

Objectives: Post-operative nausea and vomiting (PONV) is a frequently experienced complication following laparoscopic cholecystectomy. This study was planned to compare the antiemetic efficacy of palonosetron with ondansetron in patients undergoing laparoscopic cholecystectomy.

Methods: A total of 100 patients undergoing laparoscopic cholecystectomy were randomized into two groups. Group O (n=50) received ondansetron (8 mg) and Group P (n=50) received palonosetron (0.075 mg) 3 min before induction of anesthesia. Post-operatively, patients were assessed for the occurrence of nausea, retching, or vomiting at 0–2, 2–6, 6–24, 0–24, and 24–48 h time intervals. The overall incidence of PONV in time frame (0–48 h) was determined. The need of rescue antiemetic, side effect profile, and patient satisfaction scores were also assessed.

Results: The incidence and severity of nausea at all the time intervals were comparable in the two groups. The incidence of vomiting was significantly less in Group P as compared to Group O in 0–2 h (2% vs. 14%, p=0.027) and 0–24 h time intervals (10% vs. 30%, p=0.012). The overall incidence of PONV in 0–48h was lesser in Group P as compared to Group O (28% vs. 50%, p=0.024). Rescue antiemetic was required in greater number of patients in Group O as compared to Group P (p=0.038). Side effect profile and patient satisfaction scores were comparable in the two groups.

Conclusion: Palonosetron is better than ondansetron in lowering the overall incidence of PONV in 0–48 h time interval, in patients undergoing laparoscopic cholecystectomy.

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References

Daria U, Kumar V. Qualitative comparison of metoclopramide, ondansetron and granisetron alone and in combination with dexamethasone in the prevention of postoperative nausea and vomiting in day care laparoscopic gynaecological surgery under general anaesthesia. Asian J Pharm Clin Res 2012;5:165-7.

Apfel CC, Kranke P, Katz MH, Goepfert C, Papenfuss T, Rauch S, et al. Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: A randomized controlled trial of factorial design. Br J Anaesth 2002;88:659-68.

Scuderi PE, Conlay LA. Postoperative nausea and vomiting and outcome. Int Anesthesiol Clin 2003;41:165-74.

Apfel CC, Laara E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: Conclusions from cross-validations between two centers. Anesthesiology 1999;91:693-700.

Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg 2006;102:1884-98.

Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2014;118:85-113.

Moon YE, Joo J, Kim JE, Lee Y. Anti-emetic effect of ondansetron and palonosetron in thyroidectomy: A prospective, randomized, double-blind study. Br J Anaesth 2012;108:417-22.

Patel SR, Patel LJ. Development and validation of first derivative spectroscopy method for simultaneous determination of ondansetron and metoclopramide in combined dosage form. Int J Pharm Pharm Sci 2011;3:85-8.

Yang LP, Scott LJ. Palonosetron: In the prevention of nausea and vomiting. Drugs 2009;69:2257-78.

Altannak NF. Comparative lc-ms stability indicatind assays of ondansetron hydrochloride/naloxone hydrochloride and metoclopramide hydrochloride/naloxone hydrochloride used in palliative care. Int J Pharm Pharm Sci 2015;7:109-13.

Grover VK, Mathew PJ, Hegde H. Efficacy of orally disintegrating ondansetron in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy: A randomised, double-blind placebo controlled study. Anaesthesia 2009;64:595-600.

Park SK, Cho EJ. A randomized, double-blind trial of palonosetron compared with ondansetron in preventing postoperative nausea and vomiting after gynaecological laparoscopic surgery. J Int Med Res 2011;39:399-407.

Ghosh S, Pal A, Acharya A, Biswas C, Ghosh TR, Ghosh S. Palonosetron and palonosetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: A prospective, randomized, double-blind comparative study. Anesth Essays Res 2011;5:134-7.

Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 2003;97:62-71.

Yuksek MS, Alici HA, Erdem AF, Cesur M. Comparison of prophylactic anti-emetic effects of ondansetron and dexamethasone in women undergoing day-case gynaecological laparoscopic surgery. J Int Med Res 2003;31:481-8.

Laha B, Hazra A, Mallick S. Evaluation of antiemetic effect of intravenous palonosetron versus intravenous ondansetron in laparoscopic cholecystectomy: A randomized controlled trial. Indian J Pharmacol 2013;45:24-9.

Bhalla J, Baduni N, Bansal P. Comparison of palonosetron with ondansetron for postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anesthesia. J Min Access Surg 2015;11:193-7.

Bajwa SS, Bajwa SK, Kaur J, Sharma V, Singh A, Singh A, et al. Palonosetron: A novel approach to control postoperative nausea and vomiting in day care surgery. Saudi J Anaesth 2011;5:19-24.

Shadangi BK, Agrawal J, Pandey R, Kumar A, Jain S, Mittal R, et al. A prospective, randomized, double-blind, comparative study of the efficacy of intravenous ondansetron and palonosetron for prevention of postoperative nausea and vomiting. Anaesth Pain Intensive Care 2013;17:55-8.

Liu Q, Zhou C, Bao Z, Zhu Y. Effects of palonosetron and ondansetron on preventing nausea and vomiting after laparoscopic surgery. J Int Med Res 2018;46:411-20.

Published

07-12-2018

How to Cite

Kumar, A., S. Adhana, and P. Dwivedi. “A COMPARISON OF INTRAVENOUS ONDANSETRON AND PALONOSETRON IN PREVENTING POST-OPERATIVE NAUSEA AND VOMITING AFTER LAPAROSCOPIC CHOLECYSTECTOMY - A RANDOMIZED DOUBLE-BLIND STUDY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 11, no. 12, Dec. 2018, pp. 128-31, doi:10.22159/ajpcr.2018.v11i12.27712.

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