Comparison of efficacy of palonosetron-dexamethasone combination with palonosetron alone or dexamethasone alone for prophylaxis against post-operative nausea and vomiting in patients undergoing laparoscopic cholycystectomy

Abstract

Post-operative nausea and vomiting (PONV) is highly distressing and unpleasant symptom. Palonosetron and dexamethasone are effective antiemetics with minimal side effect profile. This study compared the efficacy of palonosetron dexamethasone combination with palonosetron alone and dexamethasone alone for prevention of PONV after laparoscopic cholecystectomy.This prospective, randomised, double-blind study was done on 150 adults, American Society of Anesthesiologists Grade I and II patients, aged 18-60 years undergoing laparoscopic cholecystectomy. They were allocated to three groups which were to receive either of the three treatment regimens: Group A, (n = 50) Dexamethasone 8 mg plus Palonosetron 0.075 mg OR GroupB (n = 50) Palonosetron 0.075 mg Alone OR Group C (n = 50) Dexamethasone 8 mg Alone. The primary outcome was incidence of PONV in 24 h and the secondary outcome was a number of rescue antiemetic required. One-way ANOVA test was used to compare the means amongst three groups. To compare the proportions in the groups, Chi-square test/Fisher's exact test/Two proportions Z-test was applied as appropriate.Overall incidences of PONV in the study 24 h postoperatively were 22% in group A, 42% in group B and 86% in group C in 24 h postoperatively (P < 0.001). Requirement of rescue antiemetic was more in dexamethasone group than other two groups.Palonosetron alone and palonosetron-dexamethasone combination were equally effective in the prevention of PONV. Dexamethasone alone was least effective amongst the three groups. There is no difference between palonosetron and palonosetron-dexamethasone for PONV prevention.