Abstract
Introduction: Postoperative nausea and vomiting (PONV) are prevalent symptoms after laparoscopic surgeries with an incidence rate of (54% - 79%) in bariatric procedures. Despite its popularity, limited studies assessed the effect of antiemetics for PONV prophylaxis after laparoscopic sleeve gastrectomy (LSG). The aim of this trail is to compare the effectiveness of a single pre-induction intravenous dose of Palonosetron versus Ondansetron for prophylaxis of PONV, 24 hours after LSG. Subjects and Methods: This prospective randomized controlled double-blind parallel-group study was conducted from May till December 2019. Recruited patients were consented and randomized using a closed envelop method into two groups with fifty patients each. The total number of nausea and vomiting attacks in the 24 hours postoperatively was considered as a primary end point. The secondary end points were the frequency of nausea, retching and vomiting attacks in the 24 hours post-surgery. The severity of nausea was evaluated using a 10 cm visual analogue scale (VAS). Results: This RCT included 100 patients divided into 2 groups of 50 patients each. Patients received either 75 mcg Palonosetron (Group I) or Ondansetron 4 mg (group II). Group I had statistically significant fewer episodes of nausea, retching and vomiting in the first 4 hours (P = 0.022) and from 4 to 12 hours (P = 0.024) but not after 12 hours post LSG. Total episodes of nausea, retching and vomiting in 24 hours postoperative were significantly less in group I (P = 0.021). Conclusion: A single dose of intravenous 75 mcg Palonosetron is superior to Ondansetron 4 mg in preventing PONV for patients after LSG.
Highlights
Postoperative nausea and vomiting (PONV) are prevalent symptoms after laparoscopic surgeries with an incidence rate of (54% - 79%) in bariatric procedures
Despite its popularity, limited studies assessed the effect of antiemetics for PONV prophylaxis after laparoscopic sleeve gastrectomy (LSG)
The aim of this trail is to compare the effectiveness of a single pre-induction intravenous dose of Palonosetron versus Ondansetron for prophylaxis of PONV, 24 hours after LSG
Summary
Postoperative nausea and vomiting (PONV) are prevalent symptoms after laparoscopic surgeries with an incidence rate of (54% - 79%) in bariatric procedures. Nausea and vomiting represented one of the most prevalent symptoms occurring after laparoscopic surgery especially among morbidly obese patients undergoing bariatric surgery with an incidence rate of (54% - 79%) [1] [2]. It is a major concern in the recovery period as it can result in many complications such as electrolyte abnormalities, dehydration, and aspiration of gastric content which may all lead to prolonging the hospital length of stay and delaying discharge. Studies had shown that it may be more effective than ondansetron against nausea and vomiting in patients using chemotherapy [8]
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