Comparison of Palonosetron and Dexamethasone with Ondansetron and Dexamethasone to Prevent Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

Anesth Essays Res. 2019 Apr-Jun;13(2):317-322. doi: 10.4103/aer.AER_21_19.

Abstract

Background: Laparoscopic cholecystectomy (LC) is associated with high risk of postoperative nausea and vomiting (PONV) if no prophylactic antiemetic is used.

Aims: The study compared prophylactic palonosetron and dexamethasone with ondansetron and dexamethasone in patients undergoing LC.

Setting and design: This prospective, double-blinded, randomized, controlled study was conducted at a tertiary care center.

Materials and methods: The study was carried out in 86 patients who underwent LC. The patients were randomly assigned to following study groups: Group 1 who received palonosetron (0.75 mg) with dexamethasone (8 mg) and Group II who received ondansetron (4 mg) with dexamethasone (8 mg). Patients were observed for nausea with visual analog scale and vomiting episode during 48 h postoperative follow-up.

Statistical analysis used: Data were analyzed as mean, standard deviation, percentage, and number. The following statistical tests were used: paired or unpaired t-test, Mann-Whitney test, Chi-square test, and repeated ANOVA test.

Results: There was no statistically significant difference in heart rate, mean arterial pressure, and oxygen saturation from baseline. During 48 h follow-up, the incidence of nausea, vomiting, and PONV was higher in Group II, but the difference was not statistically significant. The total dose of rescue antiemetic was 2.14 ± 4.15 mg in Group I and 5.00 ± 8.62 mg in Group II patients (P = 0.058). Headache was present in three patients in Group I and two patients of Group II.

Conclusion: The palonosetron with dexamethasone is comparable to ondansetron with dexamethasone in the prevention of PONV in patients undergoing LC.

Keywords: Laparoscopic cholecystectomy; ondansetron and dexamethasone; palonosetron; postoperative nausea and vomiting.