Comparative study between ondansetron & palonosetron in prevention of post operative nausea vomiting operated under general anaesthesia: A randomised double blind study

Abstract

Postoperative nausea vomiting [PONV] is very common complication in patient undergoing surgery. Despite various medication and patient factors anaesthesiologists continues to face discomfort in preventing PONV. This study compares the incidence of nausea and vomiting during initial 24 h post anaesthesia, need for any rescue medication, satisfaction of patients and incidence of adverse effects between ondansetron & palonosetron. In this study a total 60 patients of ASA I II, scheduled for open cholecystectomy, were selected and double blind randomization done in two groups, which either receive inj ondansetron 4mg or inj Palonosetron 75mcg before initiation of induction of anaesthesia. The events of nausea and vomiting and need of any rescue antiemetic drug was monitored at 0–2, 2–6, 6–24hrs and 0-24hrs after surgery. The visual analogue scale (VAS; 0, no nausea; 10, worst nausea) used to assess severity of PONV. Inj Metoclopramide 10 mg i.v. was adminstered as a rescue antiemetic. Adverse effects including headaches, dizziness, constipation and myalgia were recorded. Satisfaction on a three-point scale (satisfied, equivocal, dissatisfied) after 24 hr were recorded. There is increased incidence of nausea & vomiting in ondansetron than palonosetron group at 0-2, 2-6, 6-24 and at 0-24 hrs with significant difference between both groups (p value<0.05). In present study the incidence of adverse effects like presence of new headache, any dizziness, complains of myalgia, constipation were found nearly similar in both groups. In ondansetron group nearly 13% patients needed rescue antiemetic whereas in palonosetron group 7% patients needed rescue antiemetic but the difference was not significant (p value>0.05). After 24 hr of surgery patients in palonosetron group were more satisfied than ondansetron group without any significant difference (p value>0.05). Effectiveness of Palonosetron in preventing PONV found to be significantly more than that of Ondansetron. Decreased incidence of adverse effects, less need of rescue antiemetic drugs & having more patient satisfaction found in palonosetron group.